Blog Credo

The whole aim of practical politics is to keep the populace alarmed (and hence clamorous to be led to safety) by menacing it with an endless series of hobgoblins, all of them imaginary.

H.L. Mencken

Tuesday, November 29, 2016

The Assault On Healthcare

Medicare, Medicaid and now Obamacare are the essential building blocks of American health care coverage.  While a touch less than half (49%) get insurance from their employers, over a third (36%) get their insurance from the government.  Roughly 7% get their insurance from a "non-group" provider, which presumably is mostly the exchanges.

Trump's announcement that Tom Price will be his head of HHS lets you know that he will back GOP efforts to dismantle not only Obamacare, but Medicare, too.  GOP ideas to make health care "work" are pretty much terrible.  They seem to believe in Magic Unicorn Ponies like HSAs and buying across state lines that won't do much of anything to help people afford health insurance.

This is a frankly unbelievable move on the part of the Republican party.  Their electorate is overwhelmingly older and fearful. This is a natural wedge issue for Democrats.

However, the obvious concern is that the Democrats suck at politics.

Basically, Shumer has two tasks.  He has to keep his entire caucus in line.  That shouldn't be difficult.  If I'm Max Baucus or Joe Manchin I'm eager to run as a Savior of Medicare.  That fits into people's pre-existing narratives of what the parties stand for.

The trickier part will be finding three GOP Senators to preserve Medicare.  There are some natural rebels in Arizona, who also have a large elderly population to serve who could provide two votes.  Collins and Murkowski are also not prone to radical swings.  Marco Rubio has national ambitions that would probably be sunk by attacking Medicare.  Pat Toomey has shown some moderation and I wouldn't rule out even Tim Scott or Lindsay Graham breaking with their party over this.

To some degree, the assault on Medicare feels like a diversion to keep attention focused there while they dismantle Obamacare.  Maybe, but both fights are important.  And both need to be waged with discipline and ruthlessness.  There is no time for "Yes, but..." This has to be framed in terms of extremes.  Ryan and Price will argue that they aren't "ending" Medicare, they are simply introducting "choice."  Semantically that's true, but practically it's false.  Don't get caught defining terms or being reasonable.  Fight like hell.

Make the GOP radioactive heading into 2018.

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