Healthcare

Theodor Seuss Geisel’s Dump on Trump: Or, How Dr. Seuss Forecasted TrumpCare

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From a great political satirist, Dr. Seuss. In 1942. Best thing all day.

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Politics is Not Governing: Storytelling in Trump’s America

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Politics is not governing. A simple and fairly obvious statement. One which has been made ad nauseam in the days following the catastrophic failure of the American Health Care Act. A statement which is increasingly apparent to the Republican Party.

Factions, making outlandish statements for the sole purpose of media attention, and obstructionist actions are fine when you are the opposition party.  These actions made the Republican Party extremely successful under President Obama.

The Republican Party is not the opposition party. They are the majority party. They govern a unified government.

Well, “govern”.

This inability to effectively govern has highlighted an important issue for the Trump administration and the GOP. Seemingly lost in the stories about the failure of the American Health Care Act and how that legislation came to its demise is attention to the stories themselves.

The problem is not simply the articles about the GOP’s failure to pass President Trump’s first piece of major legislation. The problem is not journalists writing that Republicans have no idea how to govern and that as a consequence Paul Ryan needs to resign.

Taken in the moment these are articles about a single failure. A single failure is easily forgotten given it is followed by success. Or had been proceeded by success. A single failure can be the anomaly. When failure becomes, or is, the narrative, however, that is when a single failure is the beacon of a much larger problem.

President Trump and the Republican Party have a big problem.

Being the minority party means obstructionism and attention-seeking via whatever means necessary. Campaigning is rhetoric, promises and exploitative bushwhacking. In a word, politics. In two words, not governing.

In fact, this is essentially the opposite of governing. Consider Donald Trump’s presidential campaign and subsequent victory.

Make ridiculous statements which are readily proved demonstrably false. Draw attention to yourself by whatever means necessary. Establish strength when in public. Find your specific audience and speak to that audience at every opportunity in order to invigorate those supporters and strengthen their opinion of you.

This strategy won Donald Trump the election. But he did so without the popular vote. Without winning over new votersWithout winning over his own party.

A popular loss. A narrow Electoral College victory. Bipartisan apprehension regarding his legislative agenda. This strategy did not win Donald Trump a political mandate.

And the news following November 9th has not been any better.

Failed nomineesPotential ties to foreign governmentsProven ties to foreign governments. Alienating foreign leadersBipartisan condemnation of the President. Historically low approval ratings. A monumental defeat on President Trump’s first piece of major legislation. Doubt regarding the ability of the President to pass his next piece of major legislation. Or really any major legislation.

This succession of stories weaves a tale about President Trump and about the Republican Party. It’s a narrative. It’s a narrative of failure.

Not a single failure. Not successive failures. Simply failure.

When the narrative is failure, the narrative supposes future failure. And when future failure is supposed there is no hope for governing. Because governing requires support. Support requires the prospect of success. The prospect of success is nullified by the expectation of failure.

To illustrate this point a bit here is selection of recent media regarding the Trump administration, and the Republican Party. Apropos to President Trump, the selection is composed of tweets.

In summary, conservative news outlets/commentators/politicians criticizing the Republican Party generally, Paul Ryan specifically, and the legislation promoted by President Trump and GOP leadership. And also the President calling out his own party.

It’s a narrative. Politics instead of governing. Politics over governing.

Politics is not governing.

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We’re All Going to Die: Making America Great Again!

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The election of Donald Trump as President of the United States of America promised the end of America as we knew it. He brought the hope of a new America. America for the American people. President Trump is going to Make America Great Again.

So he says. Although many may doubt him, he means it. And the President has a plan.

Scores of Americans are apprehensive about this plan and retain stern skepticism about the greatness of America under the administration of Donald Trump. Especially as the President has had tremendous difficulties in shepherding his vision of America into reality.

Yet the President will not be deterred. President Donald Trump will Make America Great Again. The old vestiges of the American oligarchy will be destroyed. Before the new America the old must end. Existentially.

While the President’s method seemingly lacks method, it’s a process. It’s a fairly simple process.

Drastically cut spending on domestic programs so as to take away the safety net of many Americans. Ruin the environment via significant cuts to the EPA and massive steps towards deregulation. Abolish the healthcare of millionsRoll back financial regulations intended to protect people from predatory practices and stabilize the economy. Disadvantage many Americans in the job market. Further widen the chasm of partisanship which engulfs the United States. Alienate even the United States’ most staunch allies and isolate America from the world.

Only the strong survive.

Then, finally, the United States of America is no more. Only those with the demonstrated ability to endure perpetual waves of malady, survive the miasma of the heavens forcefully opened by carbon emissions, remain gainfully employed despite chronic job wars, and to stave off the intolerance of those of dissimilar political mind will abide.

These lucky few get to go to Mars. This is where the new America, the great America, will be established.

Donald Trump will Make America Great Again, he just needs to first eliminate the weak.

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Voting for the American Health Care Act: Politics vs. Policy

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As the American Health Care Act moves towards a vote on the floor of the House of Representatives on Thursday it remains a hugely unpopular bill. Despite tweaks to the initial draft of the bill to appease Republican opponents of the legislation and the appeals of President Trump the fate of this Obamacare replacement remains in doubt.

In fact, as the vote draws closer the bill actually be losing appeal.

The vast majority of analysis on this legislation concludes that the bill is deeply flawed. With the changes imposed some have noted this effort to “repeal and replace” the Affordable Care Act amounts to little more than a tax cut and Medicaid reform. It neither repeals nor replaces.

The vote on Thursday has essentially become a vote of politics versus policy.

Thereby, the question becomes, exactly what is the benefit of change for the sake of change? What is the cost of not immediately upholding a promise to repeal Obamacare when keeping that promise tangibly harms your voters? What happens when party unity is forced in the name of legislation which most agree is not worth the effort?

Absent immediate and satisfactory answers to such questions, I will instead leave with you a breviloquent, yet informative, synopsis of the decision at hand courtesy of Last Week Tonight with John Oliver.

Obamacare:

versus the American Health Care Act:

Healthcare or party loyalty? Partisanship or voters? Politics or policy?

Of course, the answers to all of these questions as well as any potential support for the American Health Care Act currently and moving forward, among Congress and the American people, may depend at least partially on something else:

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Repeal and Replace: The American Health Care Act isn’t about Healthcare

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It seems very easy to ridicule the American Health Care Act and Republican efforts to promote their plan which would replace the Affordable Care Act.

Mick Mulvaney, the director of the Office of Management and Budget told Mark Halperin on MSNBC’s “Morning Joe” that insurance coverage isn’t “the end goal” of healthcare reformIt needs be. Vice President Mike Pence told an audience in Louisville, Kentucky that healthcare in their state was made worse by ObamacareIt wasn’t.

In perhaps the epitome of Obamacare criticism, Speaker of the House Paul Ryan declared that Obamacare was in a “death spiral” because it forced healthy people to pay for sick people. A statement for which there are almost too many things wrong to properly elucidate.

Critiques of these statements, as well as others, have been swift, and harsh. And many would say such disapproving judgments are deserved. Except here’s the thing…the Republican effort to “repeal and replace” the Affordable Care Act has nothing to do with healthcare.

From the very beginning the American public liked Obamacare. They just didn’t know it due to the massive, years-long public relations campaign the GOP waged against the healthcare plan. Once talks of a Republican repeal of the Affordable Care Act became concrete, it became more popular than ever. People began to understand what the Act was and did for them. They didn’t want their healthcare taken away.

And it wouldn’t be according to Donald Trump.  The President declared “healthcare for everybody”. Furthermore, he said the government was going to pay for it.

It was quickly apparent the second statement wasn’t true. The American Health Care Act will provide tax credits, only those credits most benefit those who can already afford healthcare.

As to the President’s first statement, there was initial skepticism. Skepticism which was justified and seemingly solidified when the Congressional Budget Office’s official report on the American Health Care Act said it would increase the number of uninsured people by 24 million by 2026. In other words, according to the CBO the Republican healthcare plan will increase the number of uninsured Americans by 86 percent. It would also increase premiums in the short-term.

But remember, it isn’t about coverage. Additionally, we were already told that the CBO analysis would be wrong and meaningless.

Under Obamacare insurance premiums were skyrocketing. Quality of healthcare was plummeting. It caused the national debt to go through the roof. It destroyed jobs. It was immoral. And the CBO projections were completely wrong.

At least so argued conservatives and the Republican Party. Never mind that none of those things are true.

It isn’t about healthcare.

In fact, the Affordable Care Act took the form it did because of numerous comprises during the legislative process, compromises which incorporated many Republican ideas. The Affordable Care Act was designed a lot like a Republican comprehensive healthcare plan.

The Democrats’ original vision of comprehensive health insurance was tied to Social Security and Medicare, largely funded via payroll taxes. It would most likely have been cheaper, simpler, and more popular.

This is to say that many of the problems of Obamacare against which Republicans rail were created, or at least exacerbated, by political comprises made to incorporate Republican ideas.

There were issues with the Affordable Care Act. Even President Obama admits problems with the legislation. But the idea of revising or replacing is improvement.

To recap, many of the criticisms leveled against the Affordable Care Act by conservatives and the Republican Party are either largely the result of Republican ideas about comprehensive healthcare, fabricated by the Republican Party, or the result of creative truth-telling.

The Affordable Care Act was healthcare. “Obamacare” was politics.

Following the release of the Congressional Budget Office’s report Paul Ryan issued a statement in response:

This report confirms that the American Health Care Act will lower premiums and improve access to quality, affordable care. CBO also finds that this legislation will provide massive tax relief, dramatically reduce the deficit and make the most fundamental entitlement reform in more than a generation.

Under Obamacare, we have seen how government-mandated coverage does not equal access to care, and now the law is collapsing. Our plan is not about forcing people to buy expensive, one-size-fits-all coverage. It is about giving people more choices and better access to a plan they want and can afford. When people have more choices, costs go down. That’s what this report shows.

This is all true, except for the “all” part. And the “true” part.

The CBO does project the Republican bill would reduce the federal debt by $337 billion over the next decade. Part of the bill is eliminating tax increases made under Obamacare. And insurance premiums are projected to decrease after 2020.

Here’s the problem: the American Health Care Act is projected to cost the federal government as much as $600 billion in revenue over the same period. Those tax breaks mainly benefit the wealthy. For the poor and the elderly the cost of healthcare will increase. Especially as the initial increase in premiums and Medicaid cuts will cause many Americans to lose their insurance so when/if they attempt to pick up insurance in the future the continuous coverage premium will kick in, making it even more costly.

Even if the American Health Care Act does theoretically improve healthcare access and choices, if people can’t pay for those choices and that access, there is no healthcare.

But the American Health Care Act isn’t healthcare. The American Health Care Act is politics.

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The Republican Party unveils a Healthcare Plan: Or, Politics is not Governing

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Did you know the Affordable Care Act and “Obamacare” are one and the same? If answering in the affirmative, you can count yourself in the 67 percent of the country who gave a similar response. One-third of Americans do not understand “Obamacare” is the Affordable Care Act.

The Republican Party did a really good job. Republicans spent years lambasting the Affordable Care Act. They made up parts of the plan to make it seem less viable. Told supporters it was too expensive and provided poor healthcare.

Republicans invented “Obamacare”. They attempted for years to destroy the plan via repeal, blocking funding, court challenges, even shutting down the government.

Finally, the Republican Party got their chance. On the campaign trail Donald Trump said he would repeal Obamacare his first day in office. Following his victory he declared he would convene a special session of Congress in order to “repeal and replace” the healthcare bill.

That did not come to pass, but the political will of President Trump and the Republican Party to destroy the Affordable Care Act did not diminish. Even as it became more popular than ever. Even as the party struggled to come up with an alternative.

The Republican Party had years to develop their own healthcare system, yet seemingly spent that time coming up with new ways to combat Obamacare rather than legislating. The GOP had a very strong political response to the Affordable Care Act, but where was the alternative?

It is here. And it’s not good. As in, nobody likes it. Sparring details of the plan, just let these headlines guide you through the discontent:

  • Reuters: “Conservatives rebel against Trump-backed Republican healthcare plan”
  • New York Times: “G.O.P. Health Bill Faces Revolt from Conservative Forces”
  • Slate: “The Republican Health Care Plan Isn’t Good for Much, Except Cutting Rich Folks’ Taxes”
  • Mother Jones: “Republicans Unveil Their Health Care Plan. It’s a Bloodbath”
  • BBC: “A bumpy 24 hours for Trump-backed health bill”
  • Politico: “Trump moves to assure conservatives on Obamacare replacement plan”
  • Washington Post: “House GOP proposal to replace Obamacare sparks broad backlash”
  • Vox: “The GOP health bill doesn’t know what problem it’s trying to solve”
  • The Atlantic: “The GOP’s Plan Is Basically a $600 Billion Tax Cut for Rich Americans”
  • National Review: “Obamacare Replacement: Republican Plan is Disappointing”
  • The Hill: “Hospitals come out against GOP healthcare bill”
  • Fox News: “Conservatives balk at ObamaCare replacement bill”
  • Breitbart: “Conservatives: Paul Ryan’s Healthcare Plan Replaces Obamacare with Obamacare-lite”

As many news outlets have described, the Republican bill isn’t all that different from the plan which they have railed against. It is too similar and potentially too expensive for many conservatives. The changes the new bill does make would cut coverage for lower-income families and rolls back many health coverage gains made under the Affordable Care Act.

In other words, this new healthcare bill fails to fully repeal the Affordable Care Act which angers many conservative Republicans, yet makes just enough changes to anger Democrats and some moderate Republicans.

The question which comes to mind is, exactly for whom is this healthcare bill? Another question might be, what did the Republican Party do the past seven years?

Politics is not governing. And as the headlines highlight, this isn’t either.

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Tomorrow’s America: Donald Trump Addresses Congress

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President Donald Trump is preparing to give his first congressional address, an address during which the President has stated he will press a bold agenda to the Republican-controlled Congress. White House Press Secretary Sean Spicer said the President would highlight “public safety, including defense, increased border security, taking care of our veterans, and then economic opportunity, including education and job training, health care reform, jobs, taxes and regulatory reform.”

By most accounts President Trump will center a significant portion of his address on fulfilling many of his campaign promises. It is expected that much his speech will revolve on issues of security and public safety which candidate Trump made the focus of his campaign.

In doing so the President hopes to provide an optimistic, forward-looking vision of American life over the next four years.This is focus and optimism is expected to be highlighted in the budget proposal the President will present to Congress.

But how optimistic? What does this optimism look like? And exactly who should be optimistic?

In order to answer these questions it is necessary to examine not only what has occurred in the 38 days since the swearing-in of President Donald Trump but also to make educated guesses as to his first budget proposal. This latter aspect must be done in two parts. First, what will be in the budget proposal. And two, what will this proposal mean for policy moving forward?

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President Trump has signed a number of executive orders and presidential memorandums since taking office. A number of these deal with issues of national security and public safety. While the President’s orders to enhance controls on immigration have gotten the most attention, he has also signed orders and memoranda regarding ISIS, the Trans-Pacific Partnership, reducing the crime rate, the organization of the National Security Council and the Homeland Security Council and rebuilding the armed forces.

These priorities of the administration appear to be reflected in the President’s first budget proposal. It has been widely reported the President will seek $54 billion in additional military spending, focused mainly on military infrastructure such as ships for the Navy, planes for the Air Force and additional monies spent on U.S. nuclear forces.

This increase will be supported by requisite cuts to programs and departments related to the environment, education, science, poverty, and foreign aid.

In that the President’s budget proposal is expected to reflect his executive orders and memoranda, it is thereby informative to analyze what other budgetary priorities may be gleaned from these legislative actions.

The first executive order signed by President Trump was regarding “Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal”. It is expected that the President’s address will include at least some mention of his plan to replace the Affordable Care Act.

The problem is that the President appears to be struggling with an alternative to the healthcare program he had promised to repeal his first day in office. Furthermore, the President’s healthcare ideas seem to clash with those of congressional Republicans.

The President also signed an executive order promising making spending on infrastructure projects a priority of his administration. And he recently declared that he is still committed to rebuilding the roads and bridges of America. Just not right now. Also, it is unclear exactly how he will balance the budget and pay down the national debt while spending $550 billion on infrastructure improvements.

Additionally, paying for “the wall.”

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Another policy President Trump is expected to talk about during his address is his tax plan. The President has discussed the need for a simpler and fairer tax system in the past. And it is known the President will make changes to the tax brackets of American citizens. However, analysis of what is known about these potential changes indicate they would be more beneficial the more you make.

Politico obtained a list of 11 bullet points from the White House which purportedly outline the President’s address. According to one bullet point,

Americans can expect a speech that is grounded firmly in solving real problems for real people. How can we make sure that every American who needs a good job can get one? How can we get kids who are trapped in failing schools into a better school? How we can keep gangs and drugs and violent crime out of their neighborhoods?

Donald Trump campaigned on the promise of government for “real America”. Governance for real Americans. Policies which were not for special interests or elites. Policies which eased the burden of regular people. Policies which protected regular Americans. Real security and safety for real American citizens.

The problem is that many of President Trump’s potential policies do no such thing.

Obamacare is more popular than ever as many people begin to realize it is the same thing as the Affordable Care Act and that it provides healthcare and healthcare subsidies to those who may otherwise be left without such services. Furthermore, they now realize it may go away without a replacement.

Many Americans may no longer be able to afford healthcare if no replacement to Obamacare is put in place prior to any potential repeal, new tax plans increase their payments, there are significant cuts to the social safety netnew import taxes which may limit cheap goods available to Americans as well as decrease American exports, there remains little movement on jobs, and have their protections from corporations and special interests reduced.

A budget proposal, especially a president’s first budget proposal, is a significant signal as to how the President wants to reshape the country. In many ways this reshaping may be beneficial. President Trump will not be making cuts to entitlement programs. U.S. infrastructure is in severe disrepair. And the tax code needs to be fixed.

Yet the policies which may result from President Trump’s first budget proposal appear to do more harm than good. Hurting real Americans and harming U.S. national security.

A few of caveats are in order. First, a budget proposal is just that, a proposal. The budget put forth by the President is not automatically passed by Congress. In fact, in recent years Congress has failed to pass a budget. Second, it is unknown exactly what will be included in the budget proposal. What has been reported may be altered or altogether untrue. Finally, policies do not flow directly from a budget.

President Trump’s first congressional address promises to be a historic event. But it is unclear exactly for whom history will be beneficial.

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