“Uppity news wench” sounds like a character you’d find at a Renaissance Fair in Nutley, New Jersey (“Bring me my Uppity News Wench, for I wish to be informed of the goings on in my fair realm!” “Yes, Sire, I shall summon her at once!”)
As an already old (but fortunately still aging) Neanderthal conservative and in general a Trump supporter, I have to sadly nod my head in agreement with Mr Maurer: President Trump and Republicans really do have no plan. That is due to neither malevolence nor incompetence . . . just that no plan actually works to provide the healthcare people think they deserve with the funds actually available, even printing money as fast as the Treasury's printing plates will spin. On the other hand, Obamacare itself S'es the Fat D as Mr Maurer so memorably puts it. I still have to shop the Obamacare Marketplace for my hot young wife's policy and can guarantee that Obamacare itself, every single year, "expos[es] people to higher premiums and less coverage." I have no idea how to fix this, nor does anybody else, as long as unlimited healthcare from conception to grave, unyoked from any responsibility for individuals to actually pay for it, is considered a basic human right for citizens and non-citizens alike.
Boy that sure is weird how so many other countries are able to pull off such a fantastical trick. They just must be smarter and more right righteous I guess. The strawman of "if it's not perfect then f*** it" is hack and so is your unfrozen caveman lawyer intro.
You can constrain prices with 1) government price controls, or 2) market forces.
The root of Obamacare was to let those market forces work to bend the cost curve. Create a competitive market for insurance so people could shop with their dollars.
Well, of course the grass is always greener. And I have no idea what the reply's strawman/caveman last sentence means. About other countries' health care: the UK NHS is in shambles, the Canadians are just euthanizing their folks. The Scandinavians used to do well when they were low population, racially homogeneous, and high-trust societies--but not so much anymore.
Ignoring that this is approximately the least revelatory revelation, i.e. that Trump talks a bigger game than he actually has a plan for, dont accept the premise that Republicans have to have "a better plan". The PPACA (Obamacare by any other name) sucks. Full stop. It was an unworkable, manipulative, half baked and unconstitutional piece of cat vomit dragged from the bowels of Nancy Pelosi's policy fever dreams. President Obama happily let the Democrats of the era write whatever they wanted and he touted it happily. It was never meant to "work" . It was always destined to fail, and in its failure, Dems with their new era of "Demography is Destiny" majorities would have "fixed it" with MFA or some other single payer option.
I as a Republican dont need dick of a shit plan to understand and make the argument that repeal and return to the status quo of 2011 is better, no matter how much disruption it would cause. Setting aside the wildly unconstitutional mechanisms of it, it was also terrible policy, cooked from the beginning to produce the lowest of all possible CBO scores by kicking all the costs of it down the road, and assuming the rosiest of economic forecasts. Yes, these are bipartisan hack tricks, but the PPACA would be better for American health care if ti was taken out back and shot.
Do I, as a Republican, have some ideas about what we could do Sure. Malpractice reform and transparency in health costs would be good places to start but I flatly refuse to play the game where my reform plan gets debated against this unholy mess. The PPACA is so bad 14 years later Democrats are shutting down the government until Republicans (who weren't supposed to ever be in power again) make Obamacare their own and do the work to save it that was always going to be needed.
Remember, the open goal of people who passed the ACA was Socialized medicine and something like MFA. This was openly sold as a "first step" sort of legislation to Democrats with the subtext being "Once Republicans are weaker then we will reform this bill with what we really want".
Repeal the ACA and replace it with what was going on before it was passed. That is a better plan and will produce better outcomes, full stop.
No where in the world is it unyoked from any responsibility of individuals to actually pay for it. In countries with socialized systems tax payers pay for it. Dollars go in. Services are provided. In the US, more dollars go in for these services. What percentage of those dollars go to providing care, and what percentage go in to providing profits to the insurance companies? At the same time, as a Medicare recipient, your health insurance is paid for by my tax dollars. The most expensive users, paid for by a bargain level payroll tax of 2.9%. How much would it cost to expand that coverage to the rest?
Very few countries are genuine single-payer. While the government is significantly involved -- hey, even in the US the government pays over half the bills -- many have private markets or copays or make purchasing insurance compulsory.
Obamacare is supposed to make buying insurance compulsory, too, except that the mandate was never enforced. The system is unbalanced without that and we're seeing the system break. Young healthy people are opting out. (And why not? The boomers are the ones with the money.)
It's remarkable how many times I've been reduced to simply saying "how the FUCK do people believe this guy???", but seriously, how??? It's as if people are simply not wired to believe that someone would lie to them so blatantly for so long with absolutely nothing to back it up.
Haven’t you heard? The new plan is you tweet out into the void and then you will be hooked up by the Secretary of HHS, Captain Chemtrails himself, who forwards it to El Presidente through a helpful billionaire. Then it is like a magic spell from a fairy godmother, only way more macho, and with the speed of a man vaporizing a Venezuelan fishing boat “You shall have your cancer treatment!”
I’m surprised that no one has commented this: Obamacare (vg ACA, the creation of individual insurance markets, subsidies and penalties) *was* the healthcare plan of the Party Formerly Known as Republican. Implemented first by Mitt Romney in Massachusetts, then adapted by the Obama administration and later repudiated by the new (and no so new) Republicans.
"I simply can’t fathom why Trump wouldn’t present a plan."
Come on man, really?
The answer to this question is one you already answered pointing out the nasty and disrespectful hack job that O'Donnell did. Just look at what the Democrat media is doing today with Trump's work to build a much-needed indoor event space at the White House. A resource for the people and yet the media has enflamed those with poor emotional regulation capability to froth at the mouth about it.
Here is the thing. Half the nation are people owning cognitive behavior deficiencies. The are generally females but also feminized males. They can be gaslit to high emotive negativism about anything.
Look what they did to Project 2025. Trump could come up with a plan to end cancer, homelessness and hunger, and they would twist it into food for their derangement syndrome.
For Trump to lay out a plan, they would have a treasure trove of content to hystericize, hyperbolize and frighten people with.
I have been a professional corporate project manager. That is the profession that implements big change across the organization. We understand that in all big change there are generally three groups: For it, against it and don't know or don't care. The tend to be about equal thirds. However, without diligence and a lot of energy, those against will create a negative campaign against the change and pull some from the support group and many more from those uninformed.
If the media was good, moral and honest... not at all like the crap that O'Donnell is... maybe it would make sense to telegraph this plan. But Trump does not need to do so for campaign reasons. And it would likely backfire for that purpose anyway. And it would suck all the air out of the room and distract the Administration's agenda.
There is a way to blow past the challenge of enemies of change... that requires leveraging the decision authority of top power to make it so. It takes a visionary and someone that just steamrolls the critics. I am reading Apple in China right now and it paints Steve Jobs as taking that approach to save Apple from the failure of "decision by committee"... the approach that Democrats always take except when they pushed Obamacare, but fucked it all up because the vision of Democrats was always disingenuous... they saw it as a step toward government-run healthcare... because it would end up being a money and wealth-making bonanza for Democrats.
Trump can just wait until the mid-terms and if he still has a majority in Congress, he can just start executing on a plan.
Cost savings parts of the plan are already well underway. Eliminating the waste, fraud and abuse in Medicare and Medicaid. Getting illegal immigrants off Medicare and Medicaid. Deporting illegal immigrants. Stopping the flood of illegal immigrants. Adding work requirements for all entitlements.
The general plan approach for Republicans includes legal reforms to reduce malpractice costs, privatization moves to increase competition for providers, making it so states cannot restrict insurance and healthcare companies from competing in other state markets, tuition assistance for medical students and changes to our immigration policies to a merit-based system that favors non-woke medical doctors for example.
The general idea is going to be that the US will end up with a two-tier system where subsidized healthcare costs less than it does today, but the service levels will be lower... longer waits, etc. The other tier will be private and higher service levels. This is the same in all other countries.
> Eliminating the waste, fraud and abuse in Medicare and Medicaid
DOGE already failed. It failed a generation ago, too. Literally, "waste fraud and abuse" is a cliché.
(You should keep on applying pressure to find the fraud, and we gradually find it place by place, but it's savings on the order of a few percentage points. So far the investigations pay for themselves but turn up the WFA meter much more and you're spending more finding the fraud than you are saving by getting rid of it.)
> Getting illegal immigrants off Medicare and Medicaid
How many illegal aliens do you think are on Medicare?
> Deporting illegal immigrants
Sure, I can go with this one, but it doesn't really do much to save medical costs. It'll cost more to get hospitals built but whatever.
> Adding work requirements for all entitlements.
Okay, this is something that actually saves money. It does it by covering less people. If Joe is out of work for 6 months, he now has neither a job nor medical coverage, which technically goes into the "costs less" column. Especially if Joe dies.
> legal reforms to reduce malpractice costs
I can't believe we're still doing this one. I was you, 30 years ago, arguing that we just needed to stop malpractice suits. This is handled by the states, so how is that going? We've had enough time to see it work so there's got to be at least 1 success story. Where can we look to find it? How much cheaper is coverage in Texas?
> making it so states cannot restrict insurance and healthcare companies from competing in other state markets
This means one of two things:
1. states cannot regulate what coverage is/isn't required in their states.
2. each state gets to keep doing its own flavor of what's required, and all that you're saving is the back-end costs by having 1 company manage the many different front-ends.
Which of those 2 did you mean?
> tuition assistance for medical students
I'd rather constrain the medical schools costs but subsidizing demand is a common way of dealing with costs.
We could also stop requiring a 4-year-degree before medical school. Other countries train doctors just fine without requiring an undergraduate degree. I think you would enjoy the "Against Tulip Subsidies" essay https://slatestarcodex.com/2015/06/06/against-tulip-subsidies/
> changes to our immigration policies to a merit-based system
Great. Co-sign.
> that favors non-woke medical doctors
You accidentally typed this one out loud. I think it was meant to be part of a guest column for Jeff.
> The general idea is going to be that the US will end up with a two-tier system where subsidized healthcare costs less than it does today, but the service levels will be lower... longer waits, etc. The other tier will be private and higher service levels. This is the same in all other countries.
This is a fine idea for an overall shape of our health care system but it doesn't have much to do with all the other things you said.
Medicaid is pretty poor coverage, but it can serve as a floor, and people should want to buy themselves out of it as soon as possible. We can do that one right now.
Over here in the UK we had Boris Johnson, who promised to fix social care (basically, care for the elderly) as he literally stood on the steps on his first day in office.
As pugnacogs are mostly prostituted to finance and war, so crankitats spread themselves for health sector interests. That’s an over-generalized statement, but roughly the case. Neither Tentacle of Wealth and Power Party is going to rock their benefactors’ boats, so sanity in healthcare will have to await the engineered contagion that kills only murderous corrupt asshole scum. I am assuming, somewhat desperately, that of course this is the stack mad scientists will read first. I am sure, quite sure, the insane cackling I hear cannot be the prostituting attorney y’all ran for a gag last time, as the consequences of failing to take that election seriously has certainly taught you better by now.
“Uppity news wench” sounds like a character you’d find at a Renaissance Fair in Nutley, New Jersey (“Bring me my Uppity News Wench, for I wish to be informed of the goings on in my fair realm!” “Yes, Sire, I shall summon her at once!”)
You forgot “Big ‘The Midnight Sky’ fan”
It was in a draft! (decided to go with the more general, gettable reference)
As an already old (but fortunately still aging) Neanderthal conservative and in general a Trump supporter, I have to sadly nod my head in agreement with Mr Maurer: President Trump and Republicans really do have no plan. That is due to neither malevolence nor incompetence . . . just that no plan actually works to provide the healthcare people think they deserve with the funds actually available, even printing money as fast as the Treasury's printing plates will spin. On the other hand, Obamacare itself S'es the Fat D as Mr Maurer so memorably puts it. I still have to shop the Obamacare Marketplace for my hot young wife's policy and can guarantee that Obamacare itself, every single year, "expos[es] people to higher premiums and less coverage." I have no idea how to fix this, nor does anybody else, as long as unlimited healthcare from conception to grave, unyoked from any responsibility for individuals to actually pay for it, is considered a basic human right for citizens and non-citizens alike.
Boy that sure is weird how so many other countries are able to pull off such a fantastical trick. They just must be smarter and more right righteous I guess. The strawman of "if it's not perfect then f*** it" is hack and so is your unfrozen caveman lawyer intro.
You can constrain prices with 1) government price controls, or 2) market forces.
The root of Obamacare was to let those market forces work to bend the cost curve. Create a competitive market for insurance so people could shop with their dollars.
Well, of course the grass is always greener. And I have no idea what the reply's strawman/caveman last sentence means. About other countries' health care: the UK NHS is in shambles, the Canadians are just euthanizing their folks. The Scandinavians used to do well when they were low population, racially homogeneous, and high-trust societies--but not so much anymore.
Pop culture reference that's at least 30 years old and a reference to your fallacious argument.
Ignoring that this is approximately the least revelatory revelation, i.e. that Trump talks a bigger game than he actually has a plan for, dont accept the premise that Republicans have to have "a better plan". The PPACA (Obamacare by any other name) sucks. Full stop. It was an unworkable, manipulative, half baked and unconstitutional piece of cat vomit dragged from the bowels of Nancy Pelosi's policy fever dreams. President Obama happily let the Democrats of the era write whatever they wanted and he touted it happily. It was never meant to "work" . It was always destined to fail, and in its failure, Dems with their new era of "Demography is Destiny" majorities would have "fixed it" with MFA or some other single payer option.
I as a Republican dont need dick of a shit plan to understand and make the argument that repeal and return to the status quo of 2011 is better, no matter how much disruption it would cause. Setting aside the wildly unconstitutional mechanisms of it, it was also terrible policy, cooked from the beginning to produce the lowest of all possible CBO scores by kicking all the costs of it down the road, and assuming the rosiest of economic forecasts. Yes, these are bipartisan hack tricks, but the PPACA would be better for American health care if ti was taken out back and shot.
Do I, as a Republican, have some ideas about what we could do Sure. Malpractice reform and transparency in health costs would be good places to start but I flatly refuse to play the game where my reform plan gets debated against this unholy mess. The PPACA is so bad 14 years later Democrats are shutting down the government until Republicans (who weren't supposed to ever be in power again) make Obamacare their own and do the work to save it that was always going to be needed.
Remember, the open goal of people who passed the ACA was Socialized medicine and something like MFA. This was openly sold as a "first step" sort of legislation to Democrats with the subtext being "Once Republicans are weaker then we will reform this bill with what we really want".
Repeal the ACA and replace it with what was going on before it was passed. That is a better plan and will produce better outcomes, full stop.
No where in the world is it unyoked from any responsibility of individuals to actually pay for it. In countries with socialized systems tax payers pay for it. Dollars go in. Services are provided. In the US, more dollars go in for these services. What percentage of those dollars go to providing care, and what percentage go in to providing profits to the insurance companies? At the same time, as a Medicare recipient, your health insurance is paid for by my tax dollars. The most expensive users, paid for by a bargain level payroll tax of 2.9%. How much would it cost to expand that coverage to the rest?
Very few countries are genuine single-payer. While the government is significantly involved -- hey, even in the US the government pays over half the bills -- many have private markets or copays or make purchasing insurance compulsory.
Obamacare is supposed to make buying insurance compulsory, too, except that the mandate was never enforced. The system is unbalanced without that and we're seeing the system break. Young healthy people are opting out. (And why not? The boomers are the ones with the money.)
It's remarkable how many times I've been reduced to simply saying "how the FUCK do people believe this guy???", but seriously, how??? It's as if people are simply not wired to believe that someone would lie to them so blatantly for so long with absolutely nothing to back it up.
Haven’t you heard? The new plan is you tweet out into the void and then you will be hooked up by the Secretary of HHS, Captain Chemtrails himself, who forwards it to El Presidente through a helpful billionaire. Then it is like a magic spell from a fairy godmother, only way more macho, and with the speed of a man vaporizing a Venezuelan fishing boat “You shall have your cancer treatment!”
I’m surprised that no one has commented this: Obamacare (vg ACA, the creation of individual insurance markets, subsidies and penalties) *was* the healthcare plan of the Party Formerly Known as Republican. Implemented first by Mitt Romney in Massachusetts, then adapted by the Obama administration and later repudiated by the new (and no so new) Republicans.
"I simply can’t fathom why Trump wouldn’t present a plan."
Come on man, really?
The answer to this question is one you already answered pointing out the nasty and disrespectful hack job that O'Donnell did. Just look at what the Democrat media is doing today with Trump's work to build a much-needed indoor event space at the White House. A resource for the people and yet the media has enflamed those with poor emotional regulation capability to froth at the mouth about it.
Here is the thing. Half the nation are people owning cognitive behavior deficiencies. The are generally females but also feminized males. They can be gaslit to high emotive negativism about anything.
Look what they did to Project 2025. Trump could come up with a plan to end cancer, homelessness and hunger, and they would twist it into food for their derangement syndrome.
For Trump to lay out a plan, they would have a treasure trove of content to hystericize, hyperbolize and frighten people with.
I have been a professional corporate project manager. That is the profession that implements big change across the organization. We understand that in all big change there are generally three groups: For it, against it and don't know or don't care. The tend to be about equal thirds. However, without diligence and a lot of energy, those against will create a negative campaign against the change and pull some from the support group and many more from those uninformed.
If the media was good, moral and honest... not at all like the crap that O'Donnell is... maybe it would make sense to telegraph this plan. But Trump does not need to do so for campaign reasons. And it would likely backfire for that purpose anyway. And it would suck all the air out of the room and distract the Administration's agenda.
There is a way to blow past the challenge of enemies of change... that requires leveraging the decision authority of top power to make it so. It takes a visionary and someone that just steamrolls the critics. I am reading Apple in China right now and it paints Steve Jobs as taking that approach to save Apple from the failure of "decision by committee"... the approach that Democrats always take except when they pushed Obamacare, but fucked it all up because the vision of Democrats was always disingenuous... they saw it as a step toward government-run healthcare... because it would end up being a money and wealth-making bonanza for Democrats.
Trump can just wait until the mid-terms and if he still has a majority in Congress, he can just start executing on a plan.
Can you give us a hint as to what's in the plan?
Where do the cost savings come from?
Cost savings parts of the plan are already well underway. Eliminating the waste, fraud and abuse in Medicare and Medicaid. Getting illegal immigrants off Medicare and Medicaid. Deporting illegal immigrants. Stopping the flood of illegal immigrants. Adding work requirements for all entitlements.
The general plan approach for Republicans includes legal reforms to reduce malpractice costs, privatization moves to increase competition for providers, making it so states cannot restrict insurance and healthcare companies from competing in other state markets, tuition assistance for medical students and changes to our immigration policies to a merit-based system that favors non-woke medical doctors for example.
The general idea is going to be that the US will end up with a two-tier system where subsidized healthcare costs less than it does today, but the service levels will be lower... longer waits, etc. The other tier will be private and higher service levels. This is the same in all other countries.
> Eliminating the waste, fraud and abuse in Medicare and Medicaid
DOGE already failed. It failed a generation ago, too. Literally, "waste fraud and abuse" is a cliché.
(You should keep on applying pressure to find the fraud, and we gradually find it place by place, but it's savings on the order of a few percentage points. So far the investigations pay for themselves but turn up the WFA meter much more and you're spending more finding the fraud than you are saving by getting rid of it.)
> Getting illegal immigrants off Medicare and Medicaid
How many illegal aliens do you think are on Medicare?
> Deporting illegal immigrants
Sure, I can go with this one, but it doesn't really do much to save medical costs. It'll cost more to get hospitals built but whatever.
> Adding work requirements for all entitlements.
Okay, this is something that actually saves money. It does it by covering less people. If Joe is out of work for 6 months, he now has neither a job nor medical coverage, which technically goes into the "costs less" column. Especially if Joe dies.
> legal reforms to reduce malpractice costs
I can't believe we're still doing this one. I was you, 30 years ago, arguing that we just needed to stop malpractice suits. This is handled by the states, so how is that going? We've had enough time to see it work so there's got to be at least 1 success story. Where can we look to find it? How much cheaper is coverage in Texas?
> making it so states cannot restrict insurance and healthcare companies from competing in other state markets
This means one of two things:
1. states cannot regulate what coverage is/isn't required in their states.
2. each state gets to keep doing its own flavor of what's required, and all that you're saving is the back-end costs by having 1 company manage the many different front-ends.
Which of those 2 did you mean?
> tuition assistance for medical students
I'd rather constrain the medical schools costs but subsidizing demand is a common way of dealing with costs.
We could also stop requiring a 4-year-degree before medical school. Other countries train doctors just fine without requiring an undergraduate degree. I think you would enjoy the "Against Tulip Subsidies" essay https://slatestarcodex.com/2015/06/06/against-tulip-subsidies/
> changes to our immigration policies to a merit-based system
Great. Co-sign.
> that favors non-woke medical doctors
You accidentally typed this one out loud. I think it was meant to be part of a guest column for Jeff.
> The general idea is going to be that the US will end up with a two-tier system where subsidized healthcare costs less than it does today, but the service levels will be lower... longer waits, etc. The other tier will be private and higher service levels. This is the same in all other countries.
This is a fine idea for an overall shape of our health care system but it doesn't have much to do with all the other things you said.
Medicaid is pretty poor coverage, but it can serve as a floor, and people should want to buy themselves out of it as soon as possible. We can do that one right now.
Mostly it's about making a permission structure so people can argue "there's a better plan, uh huh."
Over here in the UK we had Boris Johnson, who promised to fix social care (basically, care for the elderly) as he literally stood on the steps on his first day in office.
Would it shock you to hear it was never even described in vague terms? https://news.sky.com/story/does-boris-johnsons-pledge-to-fix-social-care-system-stack-up-11879015
What do you expect from a real estate salesman? Details? LOL
Correction: Norah is a hot wench.
#takebackromance!
As pugnacogs are mostly prostituted to finance and war, so crankitats spread themselves for health sector interests. That’s an over-generalized statement, but roughly the case. Neither Tentacle of Wealth and Power Party is going to rock their benefactors’ boats, so sanity in healthcare will have to await the engineered contagion that kills only murderous corrupt asshole scum. I am assuming, somewhat desperately, that of course this is the stack mad scientists will read first. I am sure, quite sure, the insane cackling I hear cannot be the prostituting attorney y’all ran for a gag last time, as the consequences of failing to take that election seriously has certainly taught you better by now.
Right?