Golly, what went wrong? Well, try this. Listen to Paul Ryan explain, days before the aborted healthcare vote, why he was so gung-ho to get rid of Obamacare. “We can immediately halt the leftward drift of American social policy, while renewing prosperity through market-based, state-driven solutions that empower people instead of bureaucrats. This is the stuff of conservative dreams.”
No kidding. The stuff of ideological dreams, not the stuff of humane reality. Note that all the talk was of government, markets, social policy, prosperity, left and right with nary a syllable about health, security, medical care, disease, pain and suffering.
Yet even more zealous Reign of Terror Republicans to he right of Ryan regarded his plan as creeping socialism, despite last minute changes that would have allowed plans to deny coverage for mental illness, maternity care, addiction and so on. To people like Rand Paul, Mike Lee, and the Freedom Caucus this was still big government in charge, not free markets — free, free, free.
Except the healthcare they wanted wouldn’t have been free. For many millions it would have been prohibitively expensive giving them not better healthcare but none at all and lives such as those described by Hobbes of man in a state of nature — short, nasty and brutish. On the upside, insurers would have been free to make larger profits once freed of from requirements to provide adequate care.
Where exactly do the fantasies of the right find validation in the real world? Well, there are places on earth where everyone has healthcare that costs less per capita than in America and where the average health outcomes, including life expectancy, are better. Do they have Ayn Randian libertarian, laissez faire healthcare systems that are the stuff of conservative dreams?
They do not. By and large, they have single payer systems that eliminate the cost of insurance middlemen, control costs, treat everyone alike and tax citizens for the benefit. Oh, well that won’t do. Imagine the suffering victims of this system. They take home less in pay in exchange for never having to worry about losing healthcare if they lose a job or get too sick to work or have a catastrophic disease and get to live longer under this punishing system. The horror, the horror.
Are there places such as the Republicans seek, where markets are in control of supply and costs and government doesn’t do a damn thing to help people who are free to choose? Sure. And in most of them the poor get substandard care or none at all and are free to die in the streets like dogs.
The rich under such systems, however, are free to choose whatever care they can afford. Often, as in the cases of Saudi princes, South American caudillos, Russian oligarchs or African dictators, they fly off to Swiss clinics, the Cleveland Clinic, the Mayo Clinic or Sloan Kettering when they need a check-up.
Why? Because the level of care in their Social Darwinist, market-based places homes are so vile and because their governments do not subsidize the kind of research done by the National Institutes of Health or the CDC or teaching hospitals.
Apparently Trump didn’t notice until the last minute that the Ryan plan he tried to bully reluctant Republicans into passing did the opposite of what he’d promised voters — better healthcare for everybody at less cost. But the people in the town hall meetings of those pols and on the phones to their offices belatedly discovered he truth, that they were about to get less care for fewer people at higher cost.
It looked to them like the Ryan zealots and the inattentive, showboat president didn’t care about them or their health. The zealots cared only about their dream of shrinking government while letting unfettered markets cure all ills.
And the president cared only about putting a win on the scoreboard so he’d be better than Obama. Actually figuring out how to fix healthcare was too hard and not enough fun. All those complicated details. So, now he has announced he will let Obamacare implode and ruin lots of lives. HaHa. That will teach the Democrats a lesson.
And meanwhile, he will move on to something easy. Cutting taxes on the wealthy by gutting Medicaid and NIH and lots of other things his voters rely on. Maybe this time they won’t notice they’re going to be on the losing end, if he can get Paul to ram it through fast enough. Healthcare took too long. The hand has got to be quicker than the eye when you’re working a grift.