The healthcare plan doesn't need to be replaced, just repaired! Republicans always make a mountain out of a mole hill. The driving force behind them is not how they can make the American people better off, but, what can they do to discredit Barack Obama! To use Trump's own word, SAD.
I would like to have the same healthcare plan that the government has! Talk about equality, we would save millions maybe billions if all Senators, etc. had to purchase their own policies for healthcare. How about it, White House? Doesn't that seem fair considering most of us work much harder than anyone there?
I would like to have the same healthcare plan that the government has! Talk about equality, we would save millions maybe billions if all Senators, etc. had to purchase their own policies for healthcare. How about it, White House? Doesn't that seem fair considering most of us work much harder than anyone there?
66
I saw some of Donald Trump's supporters interviewed at his most recent campaign (hard to believe he's still campaigning) rallies in Tenn. -- it was disheartening (to put it mildly)! The comments were some of the most uninformed and ignorant that I have heard. They are now accusing former President Obama of everything Trump is being investigated and accused of. When questioned further, it's clear they have no idea what they're talking about. My first reaction is to blame the education system -- but then I realized, a lot of people, including my parents did not have a formal education, but make no mistake, they were educated -- they took their responsibilities as "citizens" seriously and honestly educated themselves on the issues. Many of these people have only educated themselves on Fox (FAKE) News and the results are terrifying. What you have now are group of ugly little Sean (I'm not a journalist) Hannity clones spewing hatred, ignorance and prejudice along with their "fearful" leader Mr. Trump. I can only hope that this is a wake up call for the majority and not the end of the Republic -- Someone in this thread said "Democracy is bigger than Donald Trump -- I pray they are correct!
141
This is what happens when conservatism becomes a cult around hatred of gov't. And then, surprisingly, takes control of gov't.
The rightwing needs to get real, and realize that the pleasant mouth noises they make to milk the grudges of cranky old white people are actually terrible, cruel policy that doesn't work.
The rightwing needs to get real, and realize that the pleasant mouth noises they make to milk the grudges of cranky old white people are actually terrible, cruel policy that doesn't work.
107
The dominant principle of conservative thought over the past number of years is that Barack Obama is a Kenyan Marxist terrorist sympathizer who wants to undermine the United States. It isn't surprising that such a philosophy doesn't produce actual policy positions.
105
You would think that this bill would shake the foundations of what conservatives like David Brooks believe in, but no, he is still nattering about "competitive, market-based health care markets to drive down costs." In the days before the ACA, when insurance companies played the market-based game, did anyone ever get lower costs? This is a myth, Mr. Brooks, and you are still pushing it. Wake up!
143
There is always a price to pay. Listening to many of the very small number of Congressional Reps chosen to speak on behalf of millions it is easy to understand that stupidity exacts its toll. Many in the USA believe that the World starts in California and ends somewhere off shore NY City. This includes undereducated Reps who give foolishness and greed human identities. Their electorate has been intentionally dumbed down to meet the needs of labor pools and prisons ....of long ago. The price being exacted now is of Americas makers of laws are displaying their idiocy to the farthest reaches of the Universe. The POTUS has already branded any American recognizing this as an elite. It is wonderful watching them, the blissfully non-elite go to hell in a handbasket while paying for multi-million shuttles of the President between his abodes. Mr. Brookes and his ilk may also claim ownership along with bottled spineless Dems. They are all my Sunday to Friday SNL.
36
"The core Republican problem is this: The Republicans can’t run policy-making from the White House because they have a marketing guy in charge of the factory. " No. A "marketing guy" would be able to understand what the public wants and present it to them in a way that they would want it as well. What we have is an amoral man, who only cares about "winning" and who would not know a real fact if it stood up and smacked him in the face.
What Republican's need to do know is easy; impeach this man for high crimes and misdemeanors. If lying about having "sex with that woman" can get someone impeached, I figure lying about everything and slandering a man should be worth it as well.
What Republican's need to do know is easy; impeach this man for high crimes and misdemeanors. If lying about having "sex with that woman" can get someone impeached, I figure lying about everything and slandering a man should be worth it as well.
197
Well, you almost got it: "I like health savings accounts, tax credits and competitive health care markets to drive down costs. But these free-market reforms have to be funded in a way to serve the least among us, not the most."
No. The free market doesn't work with health, because some of the players don't follow the laws of economics or supply and demand. Viruses don't infect those with the lowest premiums. Parkinson's disease doesn't just hit those with good long-term care. Cancer doesn't care what your lifetime caps are.
This is why no civilized country uses the free market like we do because they would also end up with poorer outcomes and higher costs, like the U.S.
Your second sentence is what the Democrats want, in the end. The free market and Republicans get in the way. Obamacare (same as Romneycare) is a compromise. Republicans now plan to make it worse in order to give riches to the rich and take benefits from the poor. The only reason the vote is still in question is that the House Freedom Caucus is trying to decide if the new plan is cruel enough.
No. The free market doesn't work with health, because some of the players don't follow the laws of economics or supply and demand. Viruses don't infect those with the lowest premiums. Parkinson's disease doesn't just hit those with good long-term care. Cancer doesn't care what your lifetime caps are.
This is why no civilized country uses the free market like we do because they would also end up with poorer outcomes and higher costs, like the U.S.
Your second sentence is what the Democrats want, in the end. The free market and Republicans get in the way. Obamacare (same as Romneycare) is a compromise. Republicans now plan to make it worse in order to give riches to the rich and take benefits from the poor. The only reason the vote is still in question is that the House Freedom Caucus is trying to decide if the new plan is cruel enough.
191
I agree Brooks analysis, But I support Obamacare or ACA.
This is not Obamacare, it is actually Romneycare national. so essence is republican a logical, thinking republican.
The very same republican party which they staunchly against abortion, forced to Mitt Romney abort his own brainchild during 2012 election. do not deny it we all watch it.
Romney care advanced Obamacare and needs to improve not repeal something is in the hands of Republicans again. But republicans are playing same stupid game as they played in 2012 and going berserk against their poor white constituency.
Brooks I do not understand one thing, everything aside what Republicans in congress are so illogical in almost every sense, where is the common wisdom.
Supposedly one the worst president in US history Nixon even established EPA, and now today's Republicans are trying to kill it.
When you compare the Todays republicans even the worst ones in the history ( such as Nixon etc) they are worse than anything we have ever experienced and saw.
Where this ILK come from?
This is not Obamacare, it is actually Romneycare national. so essence is republican a logical, thinking republican.
The very same republican party which they staunchly against abortion, forced to Mitt Romney abort his own brainchild during 2012 election. do not deny it we all watch it.
Romney care advanced Obamacare and needs to improve not repeal something is in the hands of Republicans again. But republicans are playing same stupid game as they played in 2012 and going berserk against their poor white constituency.
Brooks I do not understand one thing, everything aside what Republicans in congress are so illogical in almost every sense, where is the common wisdom.
Supposedly one the worst president in US history Nixon even established EPA, and now today's Republicans are trying to kill it.
When you compare the Todays republicans even the worst ones in the history ( such as Nixon etc) they are worse than anything we have ever experienced and saw.
Where this ILK come from?
78
Conservatives unite!
Around a president who promised that he would replace the ACA (he never called it that) with something better, cheaper, and available to all. Now he is using all his dealmaking talent to foster legislation that would do the opposite. (Since it doesn't "trump" the ACA in any way, call it "Jokercare".)
Around a congress that ....Even as a flaming elite liberal I'd have trouble improving on Mr Brooks' characterization of the congressional GOP.
Question for Mr Brooks: was the old (liberal) elite really that bad?
Around a president who promised that he would replace the ACA (he never called it that) with something better, cheaper, and available to all. Now he is using all his dealmaking talent to foster legislation that would do the opposite. (Since it doesn't "trump" the ACA in any way, call it "Jokercare".)
Around a congress that ....Even as a flaming elite liberal I'd have trouble improving on Mr Brooks' characterization of the congressional GOP.
Question for Mr Brooks: was the old (liberal) elite really that bad?
89
With 'friends like these, who needs enemies' (obnoxious republican bandits, with the boss's reverse Robin Hood stance, intent in screwing the very people that elected them to office)? With millionaires and billionaires in office, with an impossibly wide social distance, it may be unreasonable...if not impossible, to expect them to understand their miserable behavior towards the least among us. As they say, 'you cannot give what don't have'. And that includes a basic decency in understanding that justice ought not be an empty word, but a reflection of our souls by applying the 'golden rule' (do to others what you want them do unto you). It is as though you have 'swines' in congress to want to appreciate classic music, or poetry, truly human attributes that escape cold calculations of raw power, that exclude others from what they take for granted, hypocrites selling their souls to the highest bidder. And the monstrosity of the current 'sickcare' bill being rammed through in congress now is but a sample of our dehumanizing stupidity.
78
Great to see a "Republican" so clearly point out the state of our current governing majority on health care, but really it could apply to any issue. The administration and Congressional majority do not now, nor have they ever, had the common man or woman's interest in their legislative goals. Period. They simply hold fast to an outdated, disproven ideology which benefits only the most wealthy in our society. My guess is many of these same politicians would consider Mr. Brooks (and the very few moderate Republicans left) a RINO and spurn his views. As to Mr. Brooks view that the free market should be the basis of a health care system, as so many other comments have pointed out, there is NO free market in health care. I have worked in health care for 35 years and I can assure anyone that untethered free market economics will not fix our health care system. Not in regards to access or cost. It is I admit quite amusing watching the scene unfold before us but deep down incredibly sad. In the end though as long as voters keep electing people who don't have their interest at heart this madness is what we're stuck with.
247
"House members were rushed to commit to legislation..."
Not merely to "commit to," David, but to "commit" legislation. Period. In this case to commit arguably criminal (it is morally indefensible, after all) legislation.
In terms fairness and the best interests of American citizens, your stew of HSA's, tax credits and some noble but non-existent concept of "competitive" markets pales alongside a much simpler and straightforward single-payer option. Let private insurance providers exist and hawk their wares all they want. Let those who want to pay for exorbitant salaries and bonuses do so. The rest of us want someone who cares first about us, not their personal wealth.
Not merely to "commit to," David, but to "commit" legislation. Period. In this case to commit arguably criminal (it is morally indefensible, after all) legislation.
In terms fairness and the best interests of American citizens, your stew of HSA's, tax credits and some noble but non-existent concept of "competitive" markets pales alongside a much simpler and straightforward single-payer option. Let private insurance providers exist and hawk their wares all they want. Let those who want to pay for exorbitant salaries and bonuses do so. The rest of us want someone who cares first about us, not their personal wealth.
236
What a spectacle. Something this important to people's lives is merchandised by an immoral, unprincipled narcissist like its one of his ugly products. Nothing about his rise to power goes with past precedent. If this stinker bill runs aground and sinks, perhaps reality of a loss will result and justifiably start the downfall of this diseased man.
255
David said it very well. The most disgusting legislation that I have seen in my many years. What debate have we seen? Why the big rush? Obamacare took almost 2 years to pass into law. These clowns in the Congress think they can pass a much better law in 2 weeks!
President Trump will hurt those who voted for him. The working class will be screwed again starting with 'Tricky Dick' Nixon 48 years years ago; he killed 2/3 more of their sons than Johnson did in the Vietnam war. With the exception of George Bush I, every other Republican President since has screwed them with wars and reductions in taxes on the rich; i.e. Reagan & Geroge Bush II.
President Trump will hurt those who voted for him. The working class will be screwed again starting with 'Tricky Dick' Nixon 48 years years ago; he killed 2/3 more of their sons than Johnson did in the Vietnam war. With the exception of George Bush I, every other Republican President since has screwed them with wars and reductions in taxes on the rich; i.e. Reagan & Geroge Bush II.
277
"....competitive health care markets to drive down costs." Not possible in the real world. Period.
401
This just reinforces my belief that the GOP is simply incapable of creating and drafting legislation that helps the working man. They've had more than 20 years since ClintonCare, and 6 years since ObamaCare and they still have nothing.
Nothing. If they were a business, they would either be fired or declaring bankruptcy. Ironically they are indeed bankrupt, intellectually, morally and spiritually.
Nothing. If they were a business, they would either be fired or declaring bankruptcy. Ironically they are indeed bankrupt, intellectually, morally and spiritually.
141
Thanks to Brooks for pointing out not just the politics of this awful bill but the policies. They are abhorrent. Gutting Medicaid to cut more taxes for the wealthiest? Bringing back pre-existing conditions? (If it isn't in the House bill, it will show up sometime later because Cruz has already spoken of his preference for it) Pricing everyone but the richest out of the market? Indeed, it does reinforce everything we progressives have said about the heartlessness and directed cruelty of Republicans.
I hope it fails, embarrassingly so. And I hope it takes down the reputation of Trump and Ryan in particular. It's about time the curtain was pulled back on this puffed-up Speaker so America has a clear vision that the only purpose of this man's public service is to gut or eliminate as many federal programs that benefit the less fortunate as possible. He is a nasty, small-minded curmudgeon wrapped in the guise of an innocent boy scout.
I hope it fails, embarrassingly so. And I hope it takes down the reputation of Trump and Ryan in particular. It's about time the curtain was pulled back on this puffed-up Speaker so America has a clear vision that the only purpose of this man's public service is to gut or eliminate as many federal programs that benefit the less fortunate as possible. He is a nasty, small-minded curmudgeon wrapped in the guise of an innocent boy scout.
5
"I opposed Obamacare. I like ... competitive health care markets to drive down costs. "
Actually, competition as imagined by most Republicans could not work as they assume within the the healthcare system, most such proposals are on the same level of impracticality as the other policy proposals Mr, Brooks rightly derides in his column, and if he knew the facts, he would likely drop the "competition" mantra as well.
Here's a succinct explanation of why "competition" will not work as expected from a long-term mainstream observer of the heathcare system:
http://www.imaginewhatif.com/why-free-market-competition-fails-in-health...
Or, in bit more detail, and with proposals for alternative improvements.
http://www.imaginewhatif.com/3816-2/
(I've been following this commentator for years, and he's IMO one of the most knowledgeable, "go where the facts take me" analysts of the problem I've encountered.)
Actually, competition as imagined by most Republicans could not work as they assume within the the healthcare system, most such proposals are on the same level of impracticality as the other policy proposals Mr, Brooks rightly derides in his column, and if he knew the facts, he would likely drop the "competition" mantra as well.
Here's a succinct explanation of why "competition" will not work as expected from a long-term mainstream observer of the heathcare system:
http://www.imaginewhatif.com/why-free-market-competition-fails-in-health...
Or, in bit more detail, and with proposals for alternative improvements.
http://www.imaginewhatif.com/3816-2/
(I've been following this commentator for years, and he's IMO one of the most knowledgeable, "go where the facts take me" analysts of the problem I've encountered.)
5
"This bill takes the most vicious progressive stereotypes about conservatives and validates them." If only I had a nickel for every time someone used this line in writing about a piece of republican legislation - including you Mr. Brooks. Thought exercise: name a republican action in the last 20 years that doesn't validate progressive stereotypes about how cruel and short-sighted republicans have become.
7
I'm sorry David but US conservatism is about punishing the poor and empowering the rich. This is not a progressive stereotype. It's the naked truth. The days of Rockefeller Republicans are long gone. Now the GOP is about making sure that white "winners" are not taxed to subsidize non-white "losers."
Of course, many whites are poor but the GOP told them that this is because of the welfare state propping up "other people". Trump ran on this and won. Even John McCain tried to win by appealing to deluded Joe-the-plumber-types. No, David. The Republican party is about indulging the "objectivist" fantasies of Rand-reading libertarians and telling whites that they are the hard-working master race.
The Obamacare repeal fits right in to this picture. It's not just Trump needs a win. He and his new elite couldn't care less about people who need health insurance.
Of course, many whites are poor but the GOP told them that this is because of the welfare state propping up "other people". Trump ran on this and won. Even John McCain tried to win by appealing to deluded Joe-the-plumber-types. No, David. The Republican party is about indulging the "objectivist" fantasies of Rand-reading libertarians and telling whites that they are the hard-working master race.
The Obamacare repeal fits right in to this picture. It's not just Trump needs a win. He and his new elite couldn't care less about people who need health insurance.
13
"If we’re going to have the rough edges of a populist revolt, you’d think that at least somebody would be interested in listening to the people." So says Mr. Brooks.
Therein lies the rub. This populist revolt was never about the people, except in their use as a prop by the latest incarnation of P.T. Barnum. What is more dangerous is that a now thoroughly treasonous GOP rode the orange one's coattails to victory. They now control everything.
Our only hope to get our country back from these anti-government heathens is that they absolutely can't govern. They've got a sort of "reverse" Midas touch. Everything they touch will turn to excrement, which will obey the law of gravity to be deposited on the delusional people who put them into office.
The midterms can't get here soon enough. What a mess there will be to clean up.
Therein lies the rub. This populist revolt was never about the people, except in their use as a prop by the latest incarnation of P.T. Barnum. What is more dangerous is that a now thoroughly treasonous GOP rode the orange one's coattails to victory. They now control everything.
Our only hope to get our country back from these anti-government heathens is that they absolutely can't govern. They've got a sort of "reverse" Midas touch. Everything they touch will turn to excrement, which will obey the law of gravity to be deposited on the delusional people who put them into office.
The midterms can't get here soon enough. What a mess there will be to clean up.
7
This is something I very rarely say. I couldn't agree with you more, Mr. Brooks.
Your top down analysis is right on, and a great way to explain this debacle.
But why stop there? This is the way the GOP sees governance. The employers know better than the employed, the businessmen better than their customers, the CEO and the Board better than the workers, the factory owner and big farmers better than their laborers, the wealthy better than the poor, those with power better than the powerless - no matter their number.
The very use of the term "elite" rattles me with it's connotations of not just the occupying of a superior position in society, but of a concurrent actual superiority itself in the occupant, however access was gained.
Obamacare began with just such a vision as you describe - a problem perceived - millions of Americans, especially the poor and elderly and already sick - with no health insurance - and the need to fix that.
These same people cannot afford to fund "health savings accounts" and don't pay Federal Taxes so credits don't help. I was in the private market for many years - they made the mess Obama tried to fix.
Single payer. People like Medicare. It works. Health care is a basic right. Profit doesn't supply health care.
There. Let's get on to other things.
Your top down analysis is right on, and a great way to explain this debacle.
But why stop there? This is the way the GOP sees governance. The employers know better than the employed, the businessmen better than their customers, the CEO and the Board better than the workers, the factory owner and big farmers better than their laborers, the wealthy better than the poor, those with power better than the powerless - no matter their number.
The very use of the term "elite" rattles me with it's connotations of not just the occupying of a superior position in society, but of a concurrent actual superiority itself in the occupant, however access was gained.
Obamacare began with just such a vision as you describe - a problem perceived - millions of Americans, especially the poor and elderly and already sick - with no health insurance - and the need to fix that.
These same people cannot afford to fund "health savings accounts" and don't pay Federal Taxes so credits don't help. I was in the private market for many years - they made the mess Obama tried to fix.
Single payer. People like Medicare. It works. Health care is a basic right. Profit doesn't supply health care.
There. Let's get on to other things.
11
Mr. Brooks, I believe you have the central theme of the Republican approach to health care reform--trade any kind of spending reduction for a massive tax reduction for the wealthy. The reasons for that are raw class distinctions. Republican leadership cares not for the poor and needy--the undeserving. They care for and respect only wealth and money. Winners vs. losers in the language of their president. Republican leadership cares not for facts, analysis, nor examining the implications of the policy actions they wish to take. The Repulbican party is a fraud from the word go. They play to their "base" during elections and then proceed to conduct themselves to support their real constituents, the one percenters.
3
Right out there in front - the Republicans are proclaiming, like children, "We're finally going to get our way!". And they are doing it as fast as they can with out concern for the people who will need health insurance the most. And what they have made obvious is finally Robin Hood gets defeated. Take from the poor and give to the rich. People will die while the rich, who have done nothing to earn this windfall of tax cuts, eat bon-bons in their mega-mansions. If these Republican politicians didn't resemble angry children who just want their way so much and so quickly that they are screwing up new legislation, I'd just call them ugly Americans.
4
The most powerful sentence in Mr. Brooks' editorial is this one: "But these free-market reforms have to be funded in a way to serve the least among us, not the most."
The Republicans are trying to pass a tax cut for their own, pure and simple. To the devil with the American people! If I had less compassion for the millions of Americans who will suffer if this bogus bill were to become law, I'd say "Let Trump's followers experience his notion of caring about them."
The Republicans are trying to pass a tax cut for their own, pure and simple. To the devil with the American people! If I had less compassion for the millions of Americans who will suffer if this bogus bill were to become law, I'd say "Let Trump's followers experience his notion of caring about them."
7
David Brooks has written the most honest description of what is happening with the national health care legislation that I've read. Most writers and commentors can't get past their anger and their politics. Brooks shows that there are three forces working: those in favor of keeping the still-flawed Affordable Health Care Act in place, those opposed to the taxes and penalties of the AHCA that affect mostly the least needy Americans, and finally the politicians who are acting only on political expediency exacerbated by the demands of the unprincipled president. The odd thing is that the first two groups are in agreement that the new law should not be passed. The politicians are forced into schizophrenia. Thank you for the clarity, Mr. Brooks.
6
We have a President, who cannot read or comprehend. A Congress who cannot govern and live in an Ayn Rand bubble.
Although, this law could not even fool the average voter. Ryan, you are a total disgrace and exceedingly mean spirited.
Although, this law could not even fool the average voter. Ryan, you are a total disgrace and exceedingly mean spirited.
13
Sorry, Mr. Brooks, you do not get to be cogent, lucid and reasonable in these pages until we get the mea culpa you owe us all for having squandered your talent and intelligence in service to the lie of supply side economics. There is no redemption without contrition.
46
Trump has appointed the "deplorables" to his Cabinet. He seems to have a pathological hatred of President Obama. He made the birther charge and wants to undo Obama's key piece of legislation, the Affordable Care Act. Trump is also undoing his environmental actions. America has regressive policies towards national health care. The GOP favors the rich with their policies. They argue for access to health care. They regard it not as a right but something the consumer must pay for whether he or she can afford it or not. They and Trump want to do away with our progressive policies. Ryan is an advocate of Social Darwinism.
46
The Congress of the United States is the ultimate House of Lords and Liars.
The White House is occupied by a 70 year old man who had the wisdom to be born the son of a multimillionaire real estate baron in order to lead the life of a heathen hedonist pagan lord and liar.
The Trump effete are the same as the old effete. What is uncommon in politicians is humility, humanity, empathy, courage and honor.
The White House is occupied by a 70 year old man who had the wisdom to be born the son of a multimillionaire real estate baron in order to lead the life of a heathen hedonist pagan lord and liar.
The Trump effete are the same as the old effete. What is uncommon in politicians is humility, humanity, empathy, courage and honor.
52
David Brooks - this piece is brilliant. In this polarized political moment, it is reassuring to see that there is at least one person writing and speaking from the right side of the spectrum who has a conscience. I may not agree with you on the substance, but each of your conclusions is very sound:
1. There are just some politicians who want a press release called Repeal.
2. Donald Trump needs a win. The national effects of that win seem immaterial to him.
3. The Republicans can’t run policy-making from the White House because they have a marketing guy in charge of the factory. And they can’t run policy from Capitol Hill because it’s visionless and internally divided.
4. The new elite is worse than the old elite — and certainly more vapid.
Thank you for stating the truth. It gives me some hope that in the future our polarization will melt away and people of good conscience will once again meet in the middle.
1. There are just some politicians who want a press release called Repeal.
2. Donald Trump needs a win. The national effects of that win seem immaterial to him.
3. The Republicans can’t run policy-making from the White House because they have a marketing guy in charge of the factory. And they can’t run policy from Capitol Hill because it’s visionless and internally divided.
4. The new elite is worse than the old elite — and certainly more vapid.
Thank you for stating the truth. It gives me some hope that in the future our polarization will melt away and people of good conscience will once again meet in the middle.
43
Let's not kid ourselves. "Free market reforms" cannot happen if the market is distorted. In between doctors and patients, there are layers of administrative state including insurance companies, billers, administrations, MBAs, lawyers, etc. The administrative state sucks away valuable resources and they run their own course by supporting their self interests. They are not productive and they actually reduce productivity of doctors. Medical decisions became business decisions under the administrative state.
BTW, if a marketing guy should not run the factory, who should then run it? Lawyer? MBA? To make America great again, we should go back to basics and back to the "good old days" (at least in the movies). Honestly working hard should be the "strategy" and the key factor to be successful.
Of course a new administrative state is forming under the new administration. It is merely human nature. "Absolute power corrupts absolutely"! Finally, election does have consequences. I did my part and I voted for Hillary with pride.
BTW, if a marketing guy should not run the factory, who should then run it? Lawyer? MBA? To make America great again, we should go back to basics and back to the "good old days" (at least in the movies). Honestly working hard should be the "strategy" and the key factor to be successful.
Of course a new administrative state is forming under the new administration. It is merely human nature. "Absolute power corrupts absolutely"! Finally, election does have consequences. I did my part and I voted for Hillary with pride.
36
Meet the new boss, worse than the old boss.
Sad.
Sad.
36
Health care savings? really? If a family maxed out the allowed savings, roughly 6k a year, how long would it take for their savings to evaporate with a health crisis larger than a sprained ankel? And that assumes that low income workers have the luxury of putting that amount aside. A firend in Italy asked me what it would take for a Republican to consider the plight of the less fortunate and become a Democrat. My response--three months unemployment with a health care crisis. Time for a single payer system so the US, too, can join the civilized world.
119
trump would cave to *any* caucus as long as it both gave him publicity, and increased the bottom line of trump Inc. The man's only allegiance is to himself. Period.
70
Contemporary Republicans will defend the interests of the elites. What, then, should the rest of us do? Live by our wits.
All of us live inside a system that we know is complex. A conservative portion of us seeks simplicity in free markets. Leftists simplify by championing a moral principle. We are all god's children so we all deserve health care, leftists might say, perhaps without the god part.
Those who worship free markets end up not knowing much about markets. Spend decades criticizing government and you end up knowing little about how the private sphere works. And you'll know this little proudly because it is your simplifying assumption.
And leftists? In a society where everything is monetized, see how much you end up knowing about how the world works by championing a humanism bereft of awareness of business. Again, not much but also again, a proud not much because a vacuous humanism is your simplifying mantra.
We're stuck with the hard, uncertain work of trying to understand the current hyper-monetized system whatever our political inclinations might be. Adore free markets? Ok. How do you understand the point of our med school/residency system, or our current FDA/patent system? Shouldn't we import doctors from Cuba and pills from the EU? Leftists, do you know how much your preferred communities are supported by intellectual property law? What to you is a moral principle looks increasingly like blindness in defense of the interests of a professional class.
All of us live inside a system that we know is complex. A conservative portion of us seeks simplicity in free markets. Leftists simplify by championing a moral principle. We are all god's children so we all deserve health care, leftists might say, perhaps without the god part.
Those who worship free markets end up not knowing much about markets. Spend decades criticizing government and you end up knowing little about how the private sphere works. And you'll know this little proudly because it is your simplifying assumption.
And leftists? In a society where everything is monetized, see how much you end up knowing about how the world works by championing a humanism bereft of awareness of business. Again, not much but also again, a proud not much because a vacuous humanism is your simplifying mantra.
We're stuck with the hard, uncertain work of trying to understand the current hyper-monetized system whatever our political inclinations might be. Adore free markets? Ok. How do you understand the point of our med school/residency system, or our current FDA/patent system? Shouldn't we import doctors from Cuba and pills from the EU? Leftists, do you know how much your preferred communities are supported by intellectual property law? What to you is a moral principle looks increasingly like blindness in defense of the interests of a professional class.
9
More pap from David Brooks, the old-line GOP con man who had an opportunity support Secy. Clinton but declined to do so. Brooks is as guilty as the GOP clowns legislating in D.C. Quit deflecting, denying!
4
Now that we have all seen what the true "market driven" healthcare (not) plan is that Republicans want to sell us, maybe we can all start to look at universal healthcare. Every insurance company shudders at the thought of the loss of all that shareholder money and thus, their huge salaries and bonuses. Surprisingly Mr Brook, a conservative I mostly admire, understands that conservatism must be intertwined with the needs of the people. Thank you Mr Brooks.
1
Trump's lobbying for this health care bill was "substance-free," says Mr. Brooks. Yes, and so is everything Trump lobbies for. He shows little concern for the millions of working-class Americans who voted for him. How about taxes? This health bill slashes taxes for the richest Americans while putting new burdens on the poor. How about other Trump policies? Stiff tariffs? They threaten to make the price of everyday goods skyrocket for average Americans. A Muslim ban? It's not only unconstitutional, but it targets nations whose people have emigrated to America for decades and have done no harm here. The wall? An expensive boondoggle; the rate in inflow of illegal immigrants has been declining for years, and the wall would do little to stop drug trafficking. An infrastructure plan? That's a good idea, but Trump should have started with it, and how is he going to pay for it after lowering taxes, hiking military spending, etc.? Trump's plans are substance-free because HE is substance-free.
2
So, there we are: The man who mocked the handicapped has given his 3 minutes of thought to health care and washed his tiny hands of it.
Too "complicated".
Comrade Donnie only has enough brain cells left now to give thought to his $300 BILLION giveaway to the top 2%.
I opposed "Obama" care , too, David. I knew it was the creation of the right-wing think-tank, Heritage, became "Romney" care and then was morphed into the ACA.
My choice was single payer.
My choice was Canadian Care.
Why wasn't yours?
And here is the "core Republican problem": They voted 62 times to get rid of the ACA. That was the sole product of their 7 years as the "Party of NO!"
Not once in that 7 years did they give a thought to what they wanted to replace it with.
Not on the ACA and not on any other item in this entire venture.
Gorsuch, an ethical failure who wants less Roe and more torture is a prime example: He's a one-trick pony hired to do one thing only - get rid of Roe.
He will.
And then we are stuck with him for the rest of our lives.
But Gorsuch is the only one in the entire government that is not a Temp.
Comrade Donnie is a temp.
Ryan & Comrades (Koch Bros, ALEC, Meadows, and God-Fearing Pence) are all temps, but one can do a lot of damage through ignorance, malice and greed.
Unlike you, David, I make no assumption that this nation will survive. We were never terribly bright but for the last 40 years we have been terminally stupid -
- the kind of "terminal" that chemo can't cure.
Too "complicated".
Comrade Donnie only has enough brain cells left now to give thought to his $300 BILLION giveaway to the top 2%.
I opposed "Obama" care , too, David. I knew it was the creation of the right-wing think-tank, Heritage, became "Romney" care and then was morphed into the ACA.
My choice was single payer.
My choice was Canadian Care.
Why wasn't yours?
And here is the "core Republican problem": They voted 62 times to get rid of the ACA. That was the sole product of their 7 years as the "Party of NO!"
Not once in that 7 years did they give a thought to what they wanted to replace it with.
Not on the ACA and not on any other item in this entire venture.
Gorsuch, an ethical failure who wants less Roe and more torture is a prime example: He's a one-trick pony hired to do one thing only - get rid of Roe.
He will.
And then we are stuck with him for the rest of our lives.
But Gorsuch is the only one in the entire government that is not a Temp.
Comrade Donnie is a temp.
Ryan & Comrades (Koch Bros, ALEC, Meadows, and God-Fearing Pence) are all temps, but one can do a lot of damage through ignorance, malice and greed.
Unlike you, David, I make no assumption that this nation will survive. We were never terribly bright but for the last 40 years we have been terminally stupid -
- the kind of "terminal" that chemo can't cure.
6
Mr. Brooks, could we begin to cease calling the Rich 'The Elite', reminiscent for this American, as 'The Chosen Ones'? The Rich have more freedom of choice, more money, and can afford to eat organic food.
It is the first time in a long life that this American is developing a distinct aversion for the Republican Party in power. I would support an 'Old-Fashioned President', and feel better.
As usual, expect to get plowed by your readership for being a phony. You are honest, while not rejecting your Party Affiliation and you have been shouting in your own way these last few months about the dangers of a Trump Presidency.
Some of these Republicans are not all rich in funds, but comfortable enough to pay their house mortgage, or take their parents to a reputable doctor without blinking. There is going to be no populist revolt because Trump might order the National Guard to take charge of dissidents, while he continues to get crowds to rally, inciting them to rage against 'the bleeding heart liberals' who made off with our Country, and to re-charge his batteries when having a rare case of self-doubts.
You are to be commended for speaking up in your own right. It comes as no surprise that while some Americans are clinging to freedom of speech and democracy, they are mistrustful of governance. Rushing America through this Health Bill could be fatal. The G.O.P. knows it, and The New Ruling Class is less enlightened, educated, and uninformed than then the Old one.
It is the first time in a long life that this American is developing a distinct aversion for the Republican Party in power. I would support an 'Old-Fashioned President', and feel better.
As usual, expect to get plowed by your readership for being a phony. You are honest, while not rejecting your Party Affiliation and you have been shouting in your own way these last few months about the dangers of a Trump Presidency.
Some of these Republicans are not all rich in funds, but comfortable enough to pay their house mortgage, or take their parents to a reputable doctor without blinking. There is going to be no populist revolt because Trump might order the National Guard to take charge of dissidents, while he continues to get crowds to rally, inciting them to rage against 'the bleeding heart liberals' who made off with our Country, and to re-charge his batteries when having a rare case of self-doubts.
You are to be commended for speaking up in your own right. It comes as no surprise that while some Americans are clinging to freedom of speech and democracy, they are mistrustful of governance. Rushing America through this Health Bill could be fatal. The G.O.P. knows it, and The New Ruling Class is less enlightened, educated, and uninformed than then the Old one.
We could have had a public option; we could have had Medicare for all. But no, the Democrats went the path of a national RomneyCare to appease the Republicans. Too bad we didn't do it better the first time, but ACA is what it is, and now the GOP is ever so slowly realizing that appeasing their far right libertarian wing *and* keeping their moderates mollified is not so easy.
Meanwhile, amateur night in Dixie continues in the White House. This is what happens, folks, when you elect someone with no governing experience. Trump is falling back on what has worked for him the past 70 years, being a middle school bully, threatening to cut and run just as he has done so often in his much vaunted business life. Now it remains to be seen if there are *any* adults with common sense in the GOP leadership who can craft a reasonable replacement for ACA. They have been promising us one for the past 7 years; we all knew it was empty promises, and now they can either admit defeat and slink off, or do something really different.
Meanwhile, amateur night in Dixie continues in the White House. This is what happens, folks, when you elect someone with no governing experience. Trump is falling back on what has worked for him the past 70 years, being a middle school bully, threatening to cut and run just as he has done so often in his much vaunted business life. Now it remains to be seen if there are *any* adults with common sense in the GOP leadership who can craft a reasonable replacement for ACA. They have been promising us one for the past 7 years; we all knew it was empty promises, and now they can either admit defeat and slink off, or do something really different.
3
Wow David, are you seeing the light and coming over to my side? I have never seen you blasting republicans like this before.
Our republicans in congress don't really know what they are doing. They tell the voters that AHCA is better than ACA when it is clearly not (costs more, covers fewer people). All they want is to be left alone to enjoy the perks of office. Feckless. BHO is looking pretty good right now. We could do a lot worse if ACA was left in place.
Our republicans in congress don't really know what they are doing. They tell the voters that AHCA is better than ACA when it is clearly not (costs more, covers fewer people). All they want is to be left alone to enjoy the perks of office. Feckless. BHO is looking pretty good right now. We could do a lot worse if ACA was left in place.
I can't believe it! David Brooks finally realized that Paul Ryan is dishonest and has no soul. He's finally realized that there are no serious Rebublican policy makers in government. Old dogs can learn new tricks. Good boy David. If I could give you a treat I would.
5
After government mandated health insurance under Pres. Obama, activist Democratic Congressional leaders saw other targets for governement mandates, including mandated housing, mandated minimum income, and mandated tuition free education. If everyone had to purchase or have health insurance, so the thinking went, why not housing, food, education, employment (1960s anti-Poverty make-work programs?) etc.? A bread and circus solution to poverty!
The direction of the Democratic Party leftward towards socialism was obvious. One size state health care insurance however does not fit all. It doesn't fit nor does it resemble the dual health care insurance package benefits offered to employees through most private employers, usually one for management and one for non-management and unionized employees (Including ones for retirees/disabled).
At the business owner level, applying health care insurance, the GOP bill stifles the very free-market approach to health insurance it proposes to end.
Affordable free market universal health care insurance requires a complex of targeted health care insurance packages, resembling ones for state auto insurance mandates for drivers and ones for passengers with no driving license who must use state subsidized public transportation. Perhaps that division of needs is where the GOP plan ought to start replacing Obamacare. The way to eat an elephant is in small bites.
The direction of the Democratic Party leftward towards socialism was obvious. One size state health care insurance however does not fit all. It doesn't fit nor does it resemble the dual health care insurance package benefits offered to employees through most private employers, usually one for management and one for non-management and unionized employees (Including ones for retirees/disabled).
At the business owner level, applying health care insurance, the GOP bill stifles the very free-market approach to health insurance it proposes to end.
Affordable free market universal health care insurance requires a complex of targeted health care insurance packages, resembling ones for state auto insurance mandates for drivers and ones for passengers with no driving license who must use state subsidized public transportation. Perhaps that division of needs is where the GOP plan ought to start replacing Obamacare. The way to eat an elephant is in small bites.
"If we're going to have the rough edges of a populist revolt, you'd think that at least somebody would be interested in listening to the people. But with this bill the Republican leadership sets an all-time new land speed record for forgetting where you came from." Sorry, but Trump and the current Republicans didn't forgot where they came from; they were never from there. Trump’s populism was a con. He learned a few phrases which sounded like populism, and then repeated them over and over again, without understanding, or caring, what they meant. He and no intention of acting on them. It's no different than if Trump learned to say one thing is French: “Qu sont les toilettes?” (where are the toliets?) and then pretended he was from France.
"I opposed Obamacare. I like health savings accounts, tax credits and competitive health care markets to drive down costs." David, this relies on everything that's wrong with Trumpcare, or Ryancare (take your choice). Purportedly exclusively free-market systems never work, any more than a regulation free market protects the environment. Unregulated healthcare and "financial incentives" fail. The only interest of multinational corporations, like big insurance and Big Pharma, is in maximizing profit for stockholders. It's why most countries use single payer, and it's the reason no country has a successful healthcare system based on your proposal. (Sorry, Switzerland doesn’t count, it's one of the most heavily regulated systems in the world).
"I opposed Obamacare. I like health savings accounts, tax credits and competitive health care markets to drive down costs." David, this relies on everything that's wrong with Trumpcare, or Ryancare (take your choice). Purportedly exclusively free-market systems never work, any more than a regulation free market protects the environment. Unregulated healthcare and "financial incentives" fail. The only interest of multinational corporations, like big insurance and Big Pharma, is in maximizing profit for stockholders. It's why most countries use single payer, and it's the reason no country has a successful healthcare system based on your proposal. (Sorry, Switzerland doesn’t count, it's one of the most heavily regulated systems in the world).
3
"This bill takes the most vicious progressive stereotypes about conservatives and validates them."
Hmm. I don't think it's the bill that's doing that.
Maybe they're not stereotypes but rather inherent traits.
Hmm. I don't think it's the bill that's doing that.
Maybe they're not stereotypes but rather inherent traits.
10
"I like competitive health care markets to drive down costs."
Sigh.
"Health care market" is an oxymoron. Without price transparency and full information on the services to be provided available to all participants, a market cannot exist. Compel health care providers to make the changes necessary to make their industry a "market" worthy of the name, and we can have a discussion about how consumers can best function within it.
Sigh.
"Health care market" is an oxymoron. Without price transparency and full information on the services to be provided available to all participants, a market cannot exist. Compel health care providers to make the changes necessary to make their industry a "market" worthy of the name, and we can have a discussion about how consumers can best function within it.
6
Mr. Brooks, whether you want to admit it or not, you opposed Obamacare in significant part because you had the money for a health savings account, benefited from those tax credits, and had too much singular faith in "competitive markets" for a health care system that in many ways now resembles a public utility (think indoor plumbing, clean running water, and electricity).
That is not so unusual in this country. Nor is it unusual to have wealth presidents who "dabble" in real estate--note George Washington, Thomas Jefferson, Theodore Roosevelt, and Lyndon Johnson. It is more often true that wealthy folk--even if not with the out-sized accumulations of Trump's appointees--dominate national political scenes. What is unusual is that those other presidents did not govern predominantly on the behalf of their wealthy constituents: https://www.washingtonpost.com/posteverything/wp/2017/01/19/trump-rich-c... .
That is not so unusual in this country. Nor is it unusual to have wealth presidents who "dabble" in real estate--note George Washington, Thomas Jefferson, Theodore Roosevelt, and Lyndon Johnson. It is more often true that wealthy folk--even if not with the out-sized accumulations of Trump's appointees--dominate national political scenes. What is unusual is that those other presidents did not govern predominantly on the behalf of their wealthy constituents: https://www.washingtonpost.com/posteverything/wp/2017/01/19/trump-rich-c... .
7
Correction:
After government mandated health insurance under Pres. Obama, activist Democratic Congressional leaders saw other targets for government mandates, including mandated housing, mandated minimum income, and mandated tuition free education. If everyone had to purchase or have health insurance, so the thinking went, why not housing, food, education, employment (1960s anti-Poverty make-work programs?) etc.? A bread and circus solution to poverty!
The direction of the Democratic Party leftward towards socialism was obvious. One size state health care insurance however does not fit all. It doesn't fit nor does it resemble the dual health care insurance package benefits offered to employees through most private employers, usually one for management and one for non-management and unionized employees (Including ones for retirees/disabled).
At the business owner level, applying health care insurance, the GOP bill stifles the very free-market approach to health insurance that it proposes.
Affordable free market universal health care insurance requires a complex of targeted health care insurance packages, resembling ones for state auto insurance mandates for drivers and ones for passengers with no driving license who must use state subsidized public transportation. Perhaps that division of needs is where the GOP plan ought to start replacing Obamacare. The way to eat an elephant is in small bites.
After government mandated health insurance under Pres. Obama, activist Democratic Congressional leaders saw other targets for government mandates, including mandated housing, mandated minimum income, and mandated tuition free education. If everyone had to purchase or have health insurance, so the thinking went, why not housing, food, education, employment (1960s anti-Poverty make-work programs?) etc.? A bread and circus solution to poverty!
The direction of the Democratic Party leftward towards socialism was obvious. One size state health care insurance however does not fit all. It doesn't fit nor does it resemble the dual health care insurance package benefits offered to employees through most private employers, usually one for management and one for non-management and unionized employees (Including ones for retirees/disabled).
At the business owner level, applying health care insurance, the GOP bill stifles the very free-market approach to health insurance that it proposes.
Affordable free market universal health care insurance requires a complex of targeted health care insurance packages, resembling ones for state auto insurance mandates for drivers and ones for passengers with no driving license who must use state subsidized public transportation. Perhaps that division of needs is where the GOP plan ought to start replacing Obamacare. The way to eat an elephant is in small bites.
Brooks continues to face the facts, the data on healthcare. Here are some of them:
All other industrialized countries have some form of universal government run health care, mostly single payor. They get at least as good care as measured by all 16 of the bottom line public health statistics, and they do it at 40% of the cost per person. If our system were as efficient, we would save over $1.5 TRILLION each year.
www.pnhp.org & www.oecd.org, especially
http://www.oecd.org/els/health-systems/oecd-health-statistics-2014-frequ...
Here are the per capita figures for health care costs in 2013 in PPP dollars (which take cost of living into consideration) from the OECD:
OECD average - 3463
US - 8713
UK - 3235
France - 4124
Australia (similar obesity) - 3966
Germany - 4919
Denmark - 4553
The Netherlands - 5131
Canada - 4361
Israel - 2128
Switzerland (Highly regulated private insurance) - 6325
Singapore (2014) - 4037 (WHO)
Let's compare some bottom line statistics between the US and the UK which has real socialized medicine.
Life expectancy at birth:
UK - 81.1
US - 78.8
Infant Mortality (Deaths per 1,000):
UK - 3.8
US - 6.0
Maternal Mortality (WHO):
UK - 9
US - 14
The WHO using a formula developed by The Harvard School of Public Health ranks our system as 38th in the world. (France & Italy are 1 & 2). This formula doesn't include costs. Bloomberg ranked countries' systems on efficiency which does include costs. We came out as 50th out of 55.
All other industrialized countries have some form of universal government run health care, mostly single payor. They get at least as good care as measured by all 16 of the bottom line public health statistics, and they do it at 40% of the cost per person. If our system were as efficient, we would save over $1.5 TRILLION each year.
www.pnhp.org & www.oecd.org, especially
http://www.oecd.org/els/health-systems/oecd-health-statistics-2014-frequ...
Here are the per capita figures for health care costs in 2013 in PPP dollars (which take cost of living into consideration) from the OECD:
OECD average - 3463
US - 8713
UK - 3235
France - 4124
Australia (similar obesity) - 3966
Germany - 4919
Denmark - 4553
The Netherlands - 5131
Canada - 4361
Israel - 2128
Switzerland (Highly regulated private insurance) - 6325
Singapore (2014) - 4037 (WHO)
Let's compare some bottom line statistics between the US and the UK which has real socialized medicine.
Life expectancy at birth:
UK - 81.1
US - 78.8
Infant Mortality (Deaths per 1,000):
UK - 3.8
US - 6.0
Maternal Mortality (WHO):
UK - 9
US - 14
The WHO using a formula developed by The Harvard School of Public Health ranks our system as 38th in the world. (France & Italy are 1 & 2). This formula doesn't include costs. Bloomberg ranked countries' systems on efficiency which does include costs. We came out as 50th out of 55.
15
It is worse. Five things are apparent:
1. After some 7 years of fruitless fulminations against the ACA with continuous GOP promises to do better if given the chance (despite invitations to help refine the ACA), the now-majority but still fractured GOP still has no idea how to provide real, improved health care to real Americans.
2. The GOP's only strategy and its only strength are to obstruct, to "just say no." The party stands for nothing uplifting or forward-looking. It doesn't encourage or support compromise, moderation or accommodation; instead, it employs easier and simpler authoritarian yes-no strategies, my way or no way. Anything more seems to be beyond its grasp.
3. The GOP is nakedly revealed as the party of the wealthiest among us who seem even more avaricious than we understand and accept as normal.
4. Congressional GOP leaders are so isolated and self-centered that they've abrogated their oaths of office and have surrendered the supposed separate and equal Congress to the pseudo-Republican executive.
5. The GOP cannot govern. It long ago lost that capability as it sold slates of hatred, division, false security derived from equally false attestations of religious homogeneous purity to its store-front supporters who will actually fare worse under GOP rule.
1. After some 7 years of fruitless fulminations against the ACA with continuous GOP promises to do better if given the chance (despite invitations to help refine the ACA), the now-majority but still fractured GOP still has no idea how to provide real, improved health care to real Americans.
2. The GOP's only strategy and its only strength are to obstruct, to "just say no." The party stands for nothing uplifting or forward-looking. It doesn't encourage or support compromise, moderation or accommodation; instead, it employs easier and simpler authoritarian yes-no strategies, my way or no way. Anything more seems to be beyond its grasp.
3. The GOP is nakedly revealed as the party of the wealthiest among us who seem even more avaricious than we understand and accept as normal.
4. Congressional GOP leaders are so isolated and self-centered that they've abrogated their oaths of office and have surrendered the supposed separate and equal Congress to the pseudo-Republican executive.
5. The GOP cannot govern. It long ago lost that capability as it sold slates of hatred, division, false security derived from equally false attestations of religious homogeneous purity to its store-front supporters who will actually fare worse under GOP rule.
9
The people who know the most about how to cut costs in health care are health care providers (physicians, nurses, dentists, etc) who are not tied to professional organizations (such as AMA) that are invested solely in their own self-interest. The "revolt" in health care must involve hard-working clinicians who know that neither self-interested politicians nor self-interested professional organizations are intellectually capable or motivated to change health care to improve the lives of Americans. David, I am glad you mentioned "fee for service" (FFS) in this column. But FFS deserves more than passing mention. Start shouting from the hilltops!
3
It's really quite simple in the end.
Today's Republican party equals "I me mine; you, go away and die".
And this attitude is not limited to health care issues. The party has been completely subsumed by the Ayn Randian, social Darwinist, Calvinist moralists that used to make up only its fringe. Just think about what signing on to a pledge to never raise taxes (which most Republican officials have) really means, philosophically: there is no legitimate purpose for raising government revenue, or, in truth, for government at all. There is no reason to help ANYBODY that might not be able to help themselves. Let us all compete, red in tooth and claw, in all spheres, and devil take the hindmost (and most of the middle). Compassion might get in the way of natural selection. (Given that their behavior and philosophy is so in keeping with originalist Darwinism, it's funny how so many Republicans are science deniers. But I digress.)
Yeah, I'm an old lefty, who believes the government should help the people do what they would have trouble doing for themselves, like getting reasonable health care in a market that doesn't follow the openness rules of Adam Smith. But the lack of compassion, the outright Scroogian cruelty, of the modern Republican politician is stunning. I doubt TR, Rockefeller, or even Ronnie would recognize these people as kindred.
Today's Republican party equals "I me mine; you, go away and die".
And this attitude is not limited to health care issues. The party has been completely subsumed by the Ayn Randian, social Darwinist, Calvinist moralists that used to make up only its fringe. Just think about what signing on to a pledge to never raise taxes (which most Republican officials have) really means, philosophically: there is no legitimate purpose for raising government revenue, or, in truth, for government at all. There is no reason to help ANYBODY that might not be able to help themselves. Let us all compete, red in tooth and claw, in all spheres, and devil take the hindmost (and most of the middle). Compassion might get in the way of natural selection. (Given that their behavior and philosophy is so in keeping with originalist Darwinism, it's funny how so many Republicans are science deniers. But I digress.)
Yeah, I'm an old lefty, who believes the government should help the people do what they would have trouble doing for themselves, like getting reasonable health care in a market that doesn't follow the openness rules of Adam Smith. But the lack of compassion, the outright Scroogian cruelty, of the modern Republican politician is stunning. I doubt TR, Rockefeller, or even Ronnie would recognize these people as kindred.
7
"I opposed Obamacare. I like health savings accounts, tax credits and competitive health care markets to drive down costs."
We've tried this approach for generations and unless you've been living in glass bubble atop a ivory tower of self-indulgent smugness you would know it has never driven down costs nor made care more accessible.
As for Republicans and policy, they haven't as a party been representative of any cohesive governing platform for decades. Republicans remain the party of Attwater, and even from the grave the two legs of their three-legged stool prevail. Fear and greed. The third leg, as always is their god.
The core Republican problem is they are Republicans. Sworn to bite the hands that feeds their bellies while licking the boots of those that stuff their pockets.
The new elite is the old elite, it just looks different Mr. Brooks, when you're not invited to the party.
We've tried this approach for generations and unless you've been living in glass bubble atop a ivory tower of self-indulgent smugness you would know it has never driven down costs nor made care more accessible.
As for Republicans and policy, they haven't as a party been representative of any cohesive governing platform for decades. Republicans remain the party of Attwater, and even from the grave the two legs of their three-legged stool prevail. Fear and greed. The third leg, as always is their god.
The core Republican problem is they are Republicans. Sworn to bite the hands that feeds their bellies while licking the boots of those that stuff their pockets.
The new elite is the old elite, it just looks different Mr. Brooks, when you're not invited to the party.
4
Typical empty, non sequitur, self contradictory, phoned in Brooks column.
e.g.
"a bill that began to phase out our silly employment-based system, or one that increased health security for the working and middle class"
"Silly"? Seeing how the vast majority of the middle class purchase health insurance through their employer and that, for better or worse, it is the best system we have, Brook comment make no sense what so ever. It only emphasizes how completely removed from the experience of the average person Brooks himself is.
e.g.
"a bill that began to phase out our silly employment-based system, or one that increased health security for the working and middle class"
"Silly"? Seeing how the vast majority of the middle class purchase health insurance through their employer and that, for better or worse, it is the best system we have, Brook comment make no sense what so ever. It only emphasizes how completely removed from the experience of the average person Brooks himself is.
2
There is no efficient market based system. Period.
Singapore is the closest. It requires significant mandatory deductions from
wages for health savings accounts.
Singapore is the closest. It requires significant mandatory deductions from
wages for health savings accounts.
27
When David Brooks is right, he is really right. He got it just right this time (Wish I had written this!). The only thing he misses is the "why." Why are the Trumpers so determined to push the Repeal button? It's not the entire answer, but I am sure much of it has to do with hatred of Obama, so many of them furious inside their little white souls that a Black man was elected President and actually had the temerity to do some good things.
1
"They could have drafted a bill that addressed the perverse fee-for-service incentives that drive up health costs, or a bill that began to phase out our silly employment-based system, or one that increased health security for the working and middle class."
Uh, yeah they could have done that, but a bill that would have achieved those goals would be a bill to create a national health service or national, single-payer health insurance or both, so saying Republicans could have done anything of the kind is like saying Republicans could magically transform themselves into Bernie Sanders Democrats.
When are you going to publically renounce your Republican Party affiliation, David? Week after week you shake your head and click your tongue at the current GOP's wrongheadedness and ask them to find their inner Eisenhower. What's the point? There is no there there. The only thing to do is vote them out of office.
Just a month ago a Democratic Senate in 2018 seemed far fetched and a Democratic House seemed like pure fantasy. Now both are solidly within the realm of possibility. Hop on the bandwagon, David. There is only one party in this country offering real solutions, and it ain't the GOP.
Uh, yeah they could have done that, but a bill that would have achieved those goals would be a bill to create a national health service or national, single-payer health insurance or both, so saying Republicans could have done anything of the kind is like saying Republicans could magically transform themselves into Bernie Sanders Democrats.
When are you going to publically renounce your Republican Party affiliation, David? Week after week you shake your head and click your tongue at the current GOP's wrongheadedness and ask them to find their inner Eisenhower. What's the point? There is no there there. The only thing to do is vote them out of office.
Just a month ago a Democratic Senate in 2018 seemed far fetched and a Democratic House seemed like pure fantasy. Now both are solidly within the realm of possibility. Hop on the bandwagon, David. There is only one party in this country offering real solutions, and it ain't the GOP.
3
Lest we forget, a look back at the "competitive" healthcare market before Obamacare. That's the one that left forty million uninsured, that refused or dropped coverage for pre-existing conditions, that didn't cover children after 18, whose premiums and costs were escalating at a high rate, that had cheap plans that didn't cover much and had very high deductibles, that in fact did have health savings accounts. Ah, the good old days, huh, Mr. Brooks?
3
"House members were rushed to commit to legislation even while major pieces of it were still in flux, when nobody had time to read it, when the Congressional Budget Office had no time to score it, when the effect on health outcomes of actual Americans was an absolute mystery."
I recall that when the ACA was signed into law, two years after President Obama took office, Republicans complained that it was being rushed into law too quickly and without enough scrutiny:
https://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act
Now that Republicans are in charge, they're opting for even more rush and for less scrutiny.
I recall that when the ACA was signed into law, two years after President Obama took office, Republicans complained that it was being rushed into law too quickly and without enough scrutiny:
https://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act
Now that Republicans are in charge, they're opting for even more rush and for less scrutiny.
1
David Rockefeller died last week. I had the opportunity of meeting him back in the 1980's. He could have golfed like Fake 45 or hunted like the odious sons. He did not. He contributed to our great nation for 80 years. He built JP Morgan Chase, he contributed to the arts, and to the least among us. Being rich, filthy rich, does not mean you have to be evil. Fake and his clan have chosen to be evil.
3
How legislation is crafted is irrelevant when one party is so utterly corrupt, incompetent, and abjectly uncaring of the people affected by it.
45 is crazy, ignorant, and amoral. Except for the crazy, this is the republican party also.
We need:
1) see the taxes
2) launch investigation of the russia connection
3) prosecute AG sessions for perjury
4) remove nunes from the commitee
45 is crazy, ignorant, and amoral. Except for the crazy, this is the republican party also.
We need:
1) see the taxes
2) launch investigation of the russia connection
3) prosecute AG sessions for perjury
4) remove nunes from the commitee
1
But surely the mantra--that "health savings accounts, tax credits and competitive health care markets" will "drive down costs"--thinly disguises its disregard for "the least among us," and has always validated the worst stereotypes about conservatives. This is but another of his columns in which Mr. Brooks appears to deplore what is happening in Washington, only to reveal that what really bothers him is the inescapable connection between a truly deplorable administration and his own political beliefs--Biblical dog-whistles notwithstanding.
Nobody would produce a bill this bad on purpose. There is no purpose to the bill. It is if they were trying to build a Frankenstein that could walk and talk, but lost the directions, so it just lays there and twitches. The GOP has displayed breathtaking incompetence and dishonesty, especially with the economy and in foreign and military affairs, ever since Reagan, who had the largest number of officials indicted and jailed in history, and was as much of a booby as Trump, just less obnoxious about it. Without their solid voting block of ignorant misogynists and racists, to whom Reagan reached out so charmingly, brainwashed by Fox and Hate Radio and the Hilary Hating Industry to fervently believe ludicrous nonsense, they would never win an election, which is why they pander to them so shamelessly.
3
The approach to providing healthcare financing for poor, low-income working class and middle-class Americans which David Brooks favors would not work very well and would play into the hands of the insurance industry and brokerage industry far too much.
But, at least the Brooks approach is an honest conservative view of the problem. It would be far better than the travesty now being peddled by Donald Trump’s HHS Secretary Tom Price and the ridiculously dishonest Welfare-for-the-Rich bonanza touted by the phony Paul Ryan.
Ryan and his gang treat health care as a mere afterthought.
If average Americans see through this scam, there will be a high political price paid by the Republicans.
Good. Couldn’t happen to a more deserving bunch of politicians.
But, at least the Brooks approach is an honest conservative view of the problem. It would be far better than the travesty now being peddled by Donald Trump’s HHS Secretary Tom Price and the ridiculously dishonest Welfare-for-the-Rich bonanza touted by the phony Paul Ryan.
Ryan and his gang treat health care as a mere afterthought.
If average Americans see through this scam, there will be a high political price paid by the Republicans.
Good. Couldn’t happen to a more deserving bunch of politicians.
2
Erasing Obama. That is what Trump's primary mission seems to be. Whatever the reason, Trump is out to make it appear as though Obama never existed. It's personal. It has nothing to do with what his constituents want or campaign promises. And in the ultimate political arena, the executive with no political experience created the vacuum that conservatives are tripping over themselves to fill. America is returning to the nineteenth century filled with robber-barons and teeming unwashed masses. What greater liberty can there be then to have the freedom to perish of natural causes, free from medical care as certainly nature and God must intend.
1
But wait: there's more! The latest changes to the AHCA would permit policies that don't cover pregnancy or obstetrics which (when all goes well) bill out at around $30,000. These policies will be cheap, but will leave the unintendedly pregnant with a desperate decision. I call it A Very Republican Abortion.
Since Obamacare barred exclusions for pre-existing conditions (like pregnancy), the abortion rate has predictably plummeted, now to a 44-year low. If this becomes law, watch abortions soar! Catch the irony? You get it? You get it?
Since Obamacare barred exclusions for pre-existing conditions (like pregnancy), the abortion rate has predictably plummeted, now to a 44-year low. If this becomes law, watch abortions soar! Catch the irony? You get it? You get it?
2
An extremely cogent analysis.
In those terms, however, I still ask the question: why is Trump so bad at marketing? He clearly saw or created the demand, yet there seems to be no connection between that what he is selling. Bait and switch?
Perhaps, like a corporate raider or a tax evader, his real skill is in the numbers: how to manipulate the money without making product; so we will be left with nothing.
In those terms, however, I still ask the question: why is Trump so bad at marketing? He clearly saw or created the demand, yet there seems to be no connection between that what he is selling. Bait and switch?
Perhaps, like a corporate raider or a tax evader, his real skill is in the numbers: how to manipulate the money without making product; so we will be left with nothing.
2
Mr. Brooks: By now you should realize that healthcare is not a marketplace that can be competitive because consumers of healthcare services are mostly not in a position to shop for the best service at the best price. You're sick or injured and you need care, often now. Thus the best way to reduce cost is to reduce the profit motive and administrative costs. This is done elsewhere in a variety of ways. Singapore provides a combination of catastrophic care plus health savings accounts, Switzerland has care administered by tightly regulated insurance companies, other nations just provide some form of national health. The overarching point is that the rest of the developed world has near universal medical care at much lower per capita cost than we do but they also view that care as a right, not a privilege.
2
These people have no cares at all. As long as they play the meanest game they get rewarded. They are not just anti-US but anti-humanity. People with real values need to stand up and demand this sick gang of takers and torturers leave DC. Who would have thought that US voters could have been lied to this heartlessly? Biggest liars ever.
1
Health insurance companies are incentivized to deny coverage, thus increasing their profits. Our "representatives" in Washington receive huge, ongoing campaign contributions from the healthcare lobby. Meanwhile, Americans suffer from lousy health coverage. The ultimate answer is single-payer coverage for all. You know, the same coverage our "representatives" receive that is paid for by taxpayers. Every other modern country in the world covers its citizens, with lower costs and better results, than this broken for-profit system Americans must settle for. The GOP makes me sick. Literally.
4
Mr. Brooks: Please pen a column on exactly how the "free market" operates in the health care arena. Be specific. Selling insurance across state lines is irrelevant to controlling prices. Is it: "I can get my colon operation for twenty per cent off across town?" Or perhaps: "This coupon entitles me to a free rectal with every MRI?" Maybe: "Your pills are too expensive. Although I need them to save my life, I'll do without until I see a price reduction?" I'm sure your readers would be fascinated with such a column. I await it with the appropriate anticipation.
7
Bravo!
"I opposed Obamacare. I like health savings accounts, tax credits and competitive health care markets to drive down costs. But these free-market reforms have to be funded in a way to serve the least among us, not the most. This House Republican plan would increase suffering, morbidity and death among the middle class and poor in order to provide tax cuts to the rich." Good start!
We already have health savings accounts, called flexible benefit programs that needs tweaking. "Free-market" is a flat earth slogan,and competitive health care is definitively disadvantageous to the poor and middle class because we can't afford it. When many people suffer and die so that a handful of rich people can become richer is cruel, short sighted, and ultimately self destructive.
Obamacare is not a train wreck. Only 1 provider in a third of counties in America is a misdirection. LA county has over 10 million people, while most counties have fewer than 10 thousand. Premiums are not skyrocketing except in states where there are no exchanges. Obamacare is a silent whistle to Southern Strategists. It's a Pavlovian stimulus used by cynical oligarchs.
Real Conservatives like Brooks are finding their voices. Prosperity can be ours without exploiting the poor, suffering, and sick. Big pharma is prosperous in the rest of the world and will be here if parasitic pricing is regulated. We can free Americans from the hobble of employer based insurance and grow the economy. Adults only needed.
"I opposed Obamacare. I like health savings accounts, tax credits and competitive health care markets to drive down costs. But these free-market reforms have to be funded in a way to serve the least among us, not the most. This House Republican plan would increase suffering, morbidity and death among the middle class and poor in order to provide tax cuts to the rich." Good start!
We already have health savings accounts, called flexible benefit programs that needs tweaking. "Free-market" is a flat earth slogan,and competitive health care is definitively disadvantageous to the poor and middle class because we can't afford it. When many people suffer and die so that a handful of rich people can become richer is cruel, short sighted, and ultimately self destructive.
Obamacare is not a train wreck. Only 1 provider in a third of counties in America is a misdirection. LA county has over 10 million people, while most counties have fewer than 10 thousand. Premiums are not skyrocketing except in states where there are no exchanges. Obamacare is a silent whistle to Southern Strategists. It's a Pavlovian stimulus used by cynical oligarchs.
Real Conservatives like Brooks are finding their voices. Prosperity can be ours without exploiting the poor, suffering, and sick. Big pharma is prosperous in the rest of the world and will be here if parasitic pricing is regulated. We can free Americans from the hobble of employer based insurance and grow the economy. Adults only needed.
5
I am in agreement with Mr. Brooks. Shouldn't a populist revolt actually be of the people. The new bill would hurt the most vulnerable. The point of Obamacare was to help those who were struggling in a post-industrial America. Obamacare is certainly not perfect, but it is far superior to the GOP bill. The GOP bill does not take into consideration our post-industrial America. It assumes that no one is struggling. It assumes we are all rich. It is despicable.
3
Well done, again, Mr. Brooks. The bill is completely driven by the promise to repeal Obamacare with its increased taxes on the wealthy. The ability of the poor, the working class, the middle class, the disabled and the aged to obtain health care is not a factor at all, because those pushing this bill are unconcerned.
1
A sincere thanks to Mr. Brooks. It's important that people see that opposition to the Republican healthcare plan comes from not just far left liberals, but also from those that want a successful plan, not just any plan.
16
The Republicans had seven years to come up with an acceptable alternative to the ACA and they couldn't do it. Now they've cobbled together this horror of a bill at the last minute -- which fails to satisfy Trump's boastful promise of "better, cheaper health care for all" -- and concede that it will be DOA in the Senate even if it passes in the sycophantic House. Ryan et al keep spouting the same tired nonsense that Obamacare is a "disaster" when, in fact, it has found favor with more than half the population while Trumpcare of Ryancare is only supported by less than a third of the population. Keep it up GOP and you will be extinct after 2018.
13
House Speaker Paul Ryan to Rich Lowry on capping Medicaid funding: "We’ve been dreaming of this since you, and I were drinking out of a keg"
This bill was never about Obamacare. "Tax credits and competitive health care markets to drive down costs" is exactly the Heritage Foundation blueprint that built ACA.
Speaking of elites, If you ever bought health insurance, Mr. Brooks, you would know that you purchase Obamacare with after-tax income rather than the "silly employment-based system" where the purchases are made via an employer with pre-tax money.
Speaker Ryan covets converting Medicaid to block grants. This dates back to the 1980s. President Reagan pushed Medicaid block grants in 1981, House Speaker Gingrich in 1995 and President Bush in 2003, all failed.
So what is this block grant fantasy that GOP chases like a mythical unicorn? It is an opportunity to gut federal oversight of the Medicaid program and guarantees nearly $1 trillion will NOT be spent on health care services in the coming decade.
Medicaid covers over 75 million people, but two-thirds of patients in nursing homes pay for their care using Medicaid. They are the real cost of this program.
Speaker Ryan has a new plan for this costly group of people, and that is to remove coverage requirements, block grants eliminate guaranteed funding, changes an "entitlement" to an empty promise. There is a reason that this has failed for over thirty years. A lot of people are going to be hurt, but taxes will be cut.
This bill was never about Obamacare. "Tax credits and competitive health care markets to drive down costs" is exactly the Heritage Foundation blueprint that built ACA.
Speaking of elites, If you ever bought health insurance, Mr. Brooks, you would know that you purchase Obamacare with after-tax income rather than the "silly employment-based system" where the purchases are made via an employer with pre-tax money.
Speaker Ryan covets converting Medicaid to block grants. This dates back to the 1980s. President Reagan pushed Medicaid block grants in 1981, House Speaker Gingrich in 1995 and President Bush in 2003, all failed.
So what is this block grant fantasy that GOP chases like a mythical unicorn? It is an opportunity to gut federal oversight of the Medicaid program and guarantees nearly $1 trillion will NOT be spent on health care services in the coming decade.
Medicaid covers over 75 million people, but two-thirds of patients in nursing homes pay for their care using Medicaid. They are the real cost of this program.
Speaker Ryan has a new plan for this costly group of people, and that is to remove coverage requirements, block grants eliminate guaranteed funding, changes an "entitlement" to an empty promise. There is a reason that this has failed for over thirty years. A lot of people are going to be hurt, but taxes will be cut.
17
The Republicans don't care about Healthcare. It's obvious that they only care about more money for the wealthy. Despicable, contemptible people.
15
Mr. Brooks' column reminds me how easily words change their meaning to convey changing concepts and ideas. First, the word "conservative". I believe Mr. Brooks will agree to describe himself as a "conservative". Does that mean he has ANYTHING in common with the "conservative" members of Congress whose selfishness and demands that people less well off than they be cast aside and punished through the American Health Care Act? Well, no. For decades and even centuries, the word "conservative" actually conveyed an understanding that the public good would be advanced by limited government. Our contemporary "conservatives" on the other hand, are completely unaware of this historical meaning; their only concern is advancing the best interests of the rich whose favor they curry so shamelessly. The second word whose meaning has changed is "populist". A little over a century ago the word "populist" was used to describe a movement that brought together poor farmers, including both black and white, to demand decent treatment from the wealthy interests that kept them poor and helpless. Their movement fell to the pushback of those wealthy interests and now the word "populist" describes a completely different and completely hostile demographic.
Always a pleasure to read Mr. Brooks' columns although I don't believe limited government is actually going to advance the public welfare.
Always a pleasure to read Mr. Brooks' columns although I don't believe limited government is actually going to advance the public welfare.
3
Mr. Brooks pretty much nails it. He fails, however, to point out a quite obvious fact. The GOP has had SEVEN years to come with a replacement for the ACA. SEVEN years. Now here they are, with majority control of the Executive and Legislative branches of the federal government, and they're racing around like grade schoolers trying to finish their end-of-the-year homework assignment on the morning it's due. They are, indeed, a bunch of visionless, vapid fools.
8
"I opposed Obamacare. I like health savings accounts, tax credits and competitive health care markets to drive down costs. But these free-market reforms have to be funded in a way to serve the least among us, not the most. "The "least among us" - let's say the working folks who are working jobs that have no benefits and / or who are working multiple jobs and who do not qualify for Medicaid - probably have a difficult time setting aside money for an HSA, and can not eat tax credits. What is the transition ? I would like to see an in depth study of where Obamacare is going "wrong" I would like to know exactly how Obamacare has been a disaster. Give me more information. The Democrats were unable to convince voters during the election that Obamacare was NOT a disaster. I got tired of hearing repeal this disastrous healthcare in Republican ads. And how about a "so what" to all this. So what if people are uninsured, lose everything, file bankruptcy and have nothing in savings because they had a horrible healthcare tragedy? The government is going to pay then - Medicaid.
There is choice in Obamacare but some folks chose the higher deductibles without thinking how they had to have that money set aside.
Trump lost his shirt multiple times without a concern for his insurance. Banks bailed him out time and time again. That does NOT happen for the "people on the pavement." If you do care about bottom up analysis, Mr. Brooks, let's see the specifics.
There is choice in Obamacare but some folks chose the higher deductibles without thinking how they had to have that money set aside.
Trump lost his shirt multiple times without a concern for his insurance. Banks bailed him out time and time again. That does NOT happen for the "people on the pavement." If you do care about bottom up analysis, Mr. Brooks, let's see the specifics.
6
This health care bill is so bad, that I hope it is passed. It will be a rough 2 years until these dolts are voted out of office and repair can start. A ruse for a president, dolts for congress, how could things be any worse. Just wait and see. B
"But any large vision was beyond the drafters of this legislation."
That quote embodies most GOP policies. Rich children holding the reins of power, subservient to the banks and corporate America. They are the swamp.
That quote embodies most GOP policies. Rich children holding the reins of power, subservient to the banks and corporate America. They are the swamp.
11
To paraphrase Mr. Brooks "it turns out that the most vicious progressive stereotypes of conservative Republicans are validated."They find themselves caught in their most vicious lies with no way out. They are drinking their own poison.
On the one hand that's a good thing, let them drink it. On the other there will be more than 20 million innocent Americans who lose their healthcare and many of them will die because of it. The wealthy get to put more money in the bank because more people will get sick and die. Welcome to Ryan/Trumpcare.
On the one hand that's a good thing, let them drink it. On the other there will be more than 20 million innocent Americans who lose their healthcare and many of them will die because of it. The wealthy get to put more money in the bank because more people will get sick and die. Welcome to Ryan/Trumpcare.
5
What Americans should be realizing, and many are still not, is that the Republican Party is a visionless party with no intelligent underpinnings to substantiate their far right conservative agenda and use their legislative positions to further the interests of the wealthy class. This has become so obvious, at least to many of us, over the past two decades that it is still amazing that many of the voters who voted forTrump and the Republicans in Congress still fail to see the light. The stupidity of the masses knows no bounds. The Republicans have succeeded in convincing a significant minority of Americans that the ACA was bad for them and the country only to now reveal that was a lie the whole time. The Republican racist Congress were simply against it because Obama was for it and nothing more.
6
The only parts of the bill that would have an immediate effect are the tax deductions for the rich. The effective dates of the healthcare provisions are delayed. So if this all goes through, Trump gets the big WIN over Obamacare, cuts his personal taxes and figures he can avoid healthcare catastrophes to his base by effective date extensions and/or corrections that he can jam through. Not bad for a neophyte.
1
"Roberts Rules Of Order " used to be rigorously followed as systematic debate and then bipartisan bills became effective . It was protocol and process and technical writing leading to an outcome. Flawed but perhaps less toxic and purely elite opportunity to kill off some bottom dwellers.
That would be citizens and lowly payroll tax slaves. Irony oops.
Unless the courts and our security apparatus step in to annul this election and appoint another commission to have another election we are doomed.
That would be citizens and lowly payroll tax slaves. Irony oops.
Unless the courts and our security apparatus step in to annul this election and appoint another commission to have another election we are doomed.
Trump painted in words a vision of a third party that paid homage to ordinary working people and screamed for common sense and an end to political correctness to allow for honest discussion.
That vision mocked identity politics and political correctness. It put Americans first. It called for an end to the attacks on those of religious faith and mocking of their values. That is why he won.
Yet people who listened never lost sight of the words vs his deeds. So desperate were people for a call to common sense that they gambled with this madman who is joined at the hip to a Republican party that has become drunk on power and greed.
One can only wish that in time this predatory party recedes but that the fissures it has exposed will allow in the light for both parties, but more realistically the Democratic party, to build anew, building on the hunger that this mutant Trump, in Shiva like fashion has exposed.
That vision mocked identity politics and political correctness. It put Americans first. It called for an end to the attacks on those of religious faith and mocking of their values. That is why he won.
Yet people who listened never lost sight of the words vs his deeds. So desperate were people for a call to common sense that they gambled with this madman who is joined at the hip to a Republican party that has become drunk on power and greed.
One can only wish that in time this predatory party recedes but that the fissures it has exposed will allow in the light for both parties, but more realistically the Democratic party, to build anew, building on the hunger that this mutant Trump, in Shiva like fashion has exposed.
2
Silly David, it didn't take this bill to validate vicious stereotypes about conservatives. We progressives have known they are vicious for decades.
On another note, you're still spouting about HSAs, tax credits and competitive markets? Please point to a successful example of this in the world.
On another note, you're still spouting about HSAs, tax credits and competitive markets? Please point to a successful example of this in the world.
5
I thought that Brooks had nailed it better than anyone I had read. I was congratulating him and then he spoiled the whole effect by resurrecting those old tired freemarket ideas from the swamp and advocating them as if they weren´t just as bad as what what is proposed, a gift to the insurance industry. Ok for a member of the very comfortable elite but not for the rest of us. You can´t go to the emergency room and say I think I ought to have a colonoscopy or a screening for breast cancer. A routine colonoscopy screening found my cancer in the nick of time last year. Routine screenings in 2017 found a skin cancer and breast cancer in a young member of my family. The proposal on the table will not even provide a fig leaf for most of our countrymen. If it was good, congress and their families would cover themselves with it. Single payer covers everyone in Spain beautifully. The quality of care is excellent. Profit has no place in deciding who lives or dies in our free country. Civilized countries recognize healthcare as a basic human right.
343
Irrational motives have driven the Republican dislike of the ACA. They have, for short political gain, touted the repeal as their number one goal for seven years. Hence the irrational rush and zeal to replace it with the worst health care legislation in memory or even in modern history: millions will lose insurance, pay more or get a skimpy plan that does assure one thing: the profit margin of the insurance industry. Every physician organization came out against that onslaught that will disrupt the health care system in its core. Hospitals will close, patients will lose their doctors. People will be unable to pay their bills, bankruptcy will rise again, care will be delayed, occur in the ER where it does not belong and people will die. The senate will only marginally polish the rough edges of a bill that got worse and not better in the process. Elections have consequences: when distorted and fact deprived ideology meets reality disaster entails. It has a name now: TrumpNoCare.
4
Thanks for the opinion and it is to be hoped that someday you will trust your socialist instincts and join us in making a better political system -- one not based on capitalism. My point of contention is with your liking of a "competitive health care market" which seems to be a paradoxical statement. If healthcare is to be meaningful and not overwhelming in costs, then it must first be effective. Now it may be that there is some wiggle room as to what works and what doesn't, but the effectiveness of a healthcare system needs to be measured by science and data. Moreover, healthcare is provided by technically trained experts and their systems of diagnosis and cure. And so my question: how do untrained and uneducated (relative to healthcare) citizens make meaningful decisions in a so called competitive market? What happens when they make the wrong decisions? Do they just die or lose their homes? What happens when they are under age or mentally ill? What happens when competing healthcare plans advertise and emphasize some good parts of their plans and paste over the bad parts? The notion that capitalism and markets can solve healthcare problems is fundamentally wrong. Science is not a popularity contest and healthcare is not soap suds.
194
"They could have drafted a bill that...began to phase out our silly employment-based system" as Mr. Brooks states in his OP-ED column this morning.
I'm not so certain that our employment-based system is silly; rather I think it could be a model for our country's healthcare system. Many, if not most large universities, mandate their faculty and faculty families have medical insurance available through the university; one cannot be faculty without coverage. Faculty must choose between plans offered by a specific insurer or plans offered by a choice of insurers. University faculty are of all ages and all degrees of health, from the very healthy to those that utilize multiple services. The costs are minimized by the numbers of covered individuals (many universities are the employment engines of their communities..numbers of employees) which adds negotiating power for the employer AND the mandate that healthy individuals are covered.
Sounds a bit like the ACA except that the IRS penalties were not yet punitive enough to "mandate" that healthy individuals seek coverage.
The Republicans' sole interest is repeal, not improvement, of the ACA, while not improving access to care for all. Don't know why so many have difficulty coming to that conclusion.
I'm not so certain that our employment-based system is silly; rather I think it could be a model for our country's healthcare system. Many, if not most large universities, mandate their faculty and faculty families have medical insurance available through the university; one cannot be faculty without coverage. Faculty must choose between plans offered by a specific insurer or plans offered by a choice of insurers. University faculty are of all ages and all degrees of health, from the very healthy to those that utilize multiple services. The costs are minimized by the numbers of covered individuals (many universities are the employment engines of their communities..numbers of employees) which adds negotiating power for the employer AND the mandate that healthy individuals are covered.
Sounds a bit like the ACA except that the IRS penalties were not yet punitive enough to "mandate" that healthy individuals seek coverage.
The Republicans' sole interest is repeal, not improvement, of the ACA, while not improving access to care for all. Don't know why so many have difficulty coming to that conclusion.
3
Proven by this health care legislative process, the political vision of the alleged swamp drainers is really elitist and unconcerned about those who voted these visionless atavistic pols into office. Let the bill pass; let these callow law makers be held responsible for this destructive, heartless legislation which they know will hurt those who need insurance: many of their constituents. Theirs is a hypocritical decision. Happily, their self-destructive action will bring their party and its leadership into the light of truth. Let's see this morally bankrupt and unimaginative party of corporate syncophants lie their way out of their self made calamity when their voters suffer through a bad law. Can't blame it on the Democrats anymore. You break: you own it.
1
Hurray for David Brooks for at last telling it like it really is. This proposed health care reform is nothing more nor less than scamming the bottom 75% to benefit the top 2%. It is not complicated. It is evil.
5
Trump is used to people prompltly obeying his barked orders. But being the President is not like being the boss of his businesses, he has people who can actually fight back (Congress). He's not used to that, poor lamb. I'm enjoying it.
1
Had to check the tape to see if it was really D Brooks. But got to the line about health savings accounts, tax credits and free markets and knew I was in the right place. But give the man credit, he stepped out and bashed his tribe, thrashing the golden calf. Hopefully he will make it to the promised land, not just get to see it before he perishes.
1
The AHCA simply is a product of viciousness alive and well in DC and in our country. We put it in office and now we are left with no recourse when things go dangerously wrong as they have here. Last night I tried to call my Congressman--Warren Davidson about my opposition to this bill and asking him to vote no. There was no human answering the phones. The voice mail box was full. A cheery robo voice told me to try calling again some other time and press one to hang up. I did. Davidson took John Boehner's seat. This is his first term in the House. And on the night before the healthcare vote he had no one answering the phone or at least clearing and documenting the contents of the voice mail box so he could hear the opinions of his constituents. I will call back today.
3
These days, it's difficult having a national conversation on anything. Advocates or opponents of any proposed idea insist upon using words such as "disaster", "train wreck", "evil", etc. One of my personal favorites is the word pathological used to describe someone. If you don't have a medical degree you're likely not competent to have an opinion on anyone's pathology. We should all at least make an effort to tone it down somewhat. Health care really isn't that difficult. This all or nothing strategy is self defeating and stupid. It gives leadership roles to groups or individuals who are the worst offenders. Without blaming any one group or individual for this ever present spleen venting, it's obvious we are all part of the problem and we all will suffer because of it.
2
"They could have drafted a bill that addressed the perverse fee-for-service incentives that drive up health costs, or a bill that began to phase out our silly employment-based system, or one that increased health security for the working and middle class." Here is a starting point for Democrats. The ACA did address the increasing health security for the working and middle class. Now we need to not just focus on opposing the Republicans, but to address the price inflation that is happening in hospital charges, specialist fees and pharmaceutical costs. The electorate would unite behind this cause. Focus like a laser beam. We need leadership.
"...the bill was crafted by people who were insular and nearsighted, who could see only a Washington logic and couldn’t see any national or real-life logic."
Republicans won't even meet with their constituents and if they do, they tell them to shut up.
For a blessed change, DB is on the side of the rest of us, although his preferences of health savings plans and tax credits certainly highlight that he has no idea of living paycheck to paycheck with no extra money to stash away in a HSA. Come on, David, you're almost there....
Republicans won't even meet with their constituents and if they do, they tell them to shut up.
For a blessed change, DB is on the side of the rest of us, although his preferences of health savings plans and tax credits certainly highlight that he has no idea of living paycheck to paycheck with no extra money to stash away in a HSA. Come on, David, you're almost there....
201
A very Republican column. Progressives can not be guilty of having vicious stereotype opinions of conservatives if in fact those opinions are validated by conservative misdeed. And the Western world has shown that the only logical way to provide comprehensive health care at reasonable cost is through a sing!e player system or something close to it. It is immoral to make a profit off people's misery, but clearly Republicans just do not care.
1
I believe Mr. Brooks misdiagnoses the core Republican problem in making policy. It's not just because they have a marketing guy in charge. There is also a history of denying revenue increases at the Federal level, in the belief they can cut their way to prosperity. They deny the fact that cutting program funding, or making block grants to states, eventually results in the loss of services. Their intellectual dishonesty results in economic & social disasters. Defunding Planned Parenthood will not improve women's health. Withholding contraception will not reduce abortions. Cutting taxes on the wealthiest individuals will not remedy the budget problems. Privatizing healthcare and/or health insurance will not improve the Public's welfare.
Redistributions of wealth to the most fortunate individuals over the last 35 years have not raised "all boats"", but instead have led to the sinking of the Middle Class.
There is no "Free Lunch" & "A" is still "A". If we ever expect to get out of the hole we keep digging annually, there must be legislation that actually makes sense instead of just appealing to a "base" or some other political faction. Eliminating loopholes in corporate taxation & lowering the rate to 15% would be an excellent first step. Create a healthcare levy of 10 cents (or $1) on every financial transaction, whether by cash register, stock broker or hedge fund manager.
It can be done if we have the will, some intelligence & American ingenuity.
Redistributions of wealth to the most fortunate individuals over the last 35 years have not raised "all boats"", but instead have led to the sinking of the Middle Class.
There is no "Free Lunch" & "A" is still "A". If we ever expect to get out of the hole we keep digging annually, there must be legislation that actually makes sense instead of just appealing to a "base" or some other political faction. Eliminating loopholes in corporate taxation & lowering the rate to 15% would be an excellent first step. Create a healthcare levy of 10 cents (or $1) on every financial transaction, whether by cash register, stock broker or hedge fund manager.
It can be done if we have the will, some intelligence & American ingenuity.
1
HELP WANTED: A solid, responsible, grounded conservative party is needed. We ask that this party play the role of the budget conscious, traditional values loving, stubborn curmudgeon. We want a party that doesn't like hippies, but sees the value moderate liberals and likes to work with them to help craft legislation that benefits the many over the few without ruining free market incentives for that same few. We want a conservative party that refuses to pander far right and racist groups. We want a party that believes in fairness above winning, substance above style and kindness above corporate profits. Finally, we want to party that believes in Jesus, but that doesn't think that it is a good idea when religion mixes with politics. Send resumes and a letter of recommendation to: The American People, All-over U.S.A. PO Box 07041776
Nailed it, Mr Brooks. Trump doesn't care about policy - through his adult life he's been for/against most policies people care about - depending on the environment and what he wanted from them.
He's a come-lately Republican (his own children couldn't vote in the Republican primary because they weren't even registered in the party) - he doesn't hold Republican ideals closely, it became a way to win, in this case the Presidency.
He promised everything because he cares about nothing beyond himself and he's doing fine - his business (real business) is booming; he gets to jet down to Florida on our dime, he gets to stage rallies where crowds adore him (adoration is his drug of choice).
Bottom line, Trump will do well (if he doesn't win re-election' he'll blame everyone else), the wealthy will do well (that's him too), the country and most of its inhabitants will do poorly and many will blame Obama and Hillary.
He's a come-lately Republican (his own children couldn't vote in the Republican primary because they weren't even registered in the party) - he doesn't hold Republican ideals closely, it became a way to win, in this case the Presidency.
He promised everything because he cares about nothing beyond himself and he's doing fine - his business (real business) is booming; he gets to jet down to Florida on our dime, he gets to stage rallies where crowds adore him (adoration is his drug of choice).
Bottom line, Trump will do well (if he doesn't win re-election' he'll blame everyone else), the wealthy will do well (that's him too), the country and most of its inhabitants will do poorly and many will blame Obama and Hillary.
Finally Brooks writes something I can agree with.
i just wish he hadn't done so much to get us to this point. It's hard to forgive his past, which brought us here.
i just wish he hadn't done so much to get us to this point. It's hard to forgive his past, which brought us here.
"I opposed Obamacare. I like health savings accounts, tax credits and competitive health care markets to drive down costs. But these free-market reforms have to be funded in a way to serve the least among us, not the most."
I opposed Obamacare too... but from the opposite side of the political spectrum. I support single payer because I have no confidence in the insurance industry's desire to compete and my back-of-the-envelope calculations tell me that in order to fund the "solutions" Mr. Brooks and his establishment GOP members want "in a way to serve the least among us" you'd end up spending more money than if you gave everyone the health insurance they need. Any solution that allows the insurance industry to intermediate and make a profit will ultimately cost more than any solution that involves only the government.... because the government doesn't have to answer to shareholders who want more money, it has to answer to taxpayers who want to watch every dollar.
I opposed Obamacare too... but from the opposite side of the political spectrum. I support single payer because I have no confidence in the insurance industry's desire to compete and my back-of-the-envelope calculations tell me that in order to fund the "solutions" Mr. Brooks and his establishment GOP members want "in a way to serve the least among us" you'd end up spending more money than if you gave everyone the health insurance they need. Any solution that allows the insurance industry to intermediate and make a profit will ultimately cost more than any solution that involves only the government.... because the government doesn't have to answer to shareholders who want more money, it has to answer to taxpayers who want to watch every dollar.
1
"Vapid" is not the word I would have used. "Malevolent" perhaps.
"I like health savings accounts"
David, please understand a couple of things.
First, on the bronze plans (the cheapest ones), I've seen deductibles as high as $10-11,000. People purchase bronze plans because they can't afford more, and those people will never save $10,000 even once.
Second, deductibles are PER YEAR. A family with a chronically ill member will need to come up with another $10,000 every twelve months. This is simply not going to happen for people who make only, say, $25-30,000 per year.
David, please understand a couple of things.
First, on the bronze plans (the cheapest ones), I've seen deductibles as high as $10-11,000. People purchase bronze plans because they can't afford more, and those people will never save $10,000 even once.
Second, deductibles are PER YEAR. A family with a chronically ill member will need to come up with another $10,000 every twelve months. This is simply not going to happen for people who make only, say, $25-30,000 per year.
1
There's an upside in the wind. As a result of the incompetence, greed and self-serving agenda that have been bared for all to see, many of us have come to a fresh realization of how great America is and has been, and how delicate and precious this American democracy can be, something to treasure and preserve at all costs, not squandered as the salve to heal a broken man-child.
trump will destroy this country if we let him. Let's not.
trump will destroy this country if we let him. Let's not.
3
While I agree on substance with Dudeist Priest, Mr. Brooks, I am glad to see you have come to the point where you no longer view Paul Ryan as one of the great, serious policy wonks out there. After all, you were one of the ones who first came out years ago and annointed him. However, he is clearly no different from the rest. Krugman was right all along about him.
1
Republican values and priorities have been on full display ever since the faux wunderkind of American conservatism, Paul Ryan, first laid out his now famous budget; multiple times. It's all there. Repeal and replace ObamaCare because it has mandates, tax increases to finance care for the needy and a complicated structure made necessary by its adherence to private insurance markets. Convert Medicare into a discount coupon program to get government out of health care entirely. Peal back Social Security because wealthy people don't need it. And while we're at it cut taxes for the wealthy because if you feed the horses you'll eventually be feeding the birds. I think, finally, the American people are done with all that. We'll see if I'm right in 2018.
1
The only problem I have with this bill is that the President is a white guy.
86
Mr. Brooks,
This is the most coherent, scathing commentary on the health "care" bill that I have read.
You have made clear your opposition to the current President and his machinations from day one. Your statement that his efforts were "substance-free", captures the nature of the man perfectly.
Thanks
This is the most coherent, scathing commentary on the health "care" bill that I have read.
You have made clear your opposition to the current President and his machinations from day one. Your statement that his efforts were "substance-free", captures the nature of the man perfectly.
Thanks
36
Even as they lay dying, uninsured in their beds, Trump's voters will say "At least the President will build the wall and my grandkids won't have to bow down to no Islams." To me this seems the central conflict between the two halves of America: pay as you go, by yourself, or pitch into a common pool, depleted though it may be, for all to draw from. That and the blatant fear and hatred of anyone who isn't white.
17
David, for the first time in decades (it might not actually have been that long) I agree with you. This piece is an insightful analysis of typical Republican politics. The only point of contention is your claim that health care savings accounts will help people who don't have savings. That is the old Republican in you trying to get make sense where, clearly, none is to be made.
12
Trump and GOP want to make America like Russia where Oligarchs control everything and everybody. Look at the data bill that's going to be signed into law.
We are in grave danger with Trump, Republicans and Putin a trifecta that is beyond the infernal regions.
We are in grave danger with Trump, Republicans and Putin a trifecta that is beyond the infernal regions.
11
Amen. I would only add that the saddest reality of all about this bill is that those who will be most negatively affected by it are not reading this column or anything else, if they did read it they'd call it fake news because all they want is Trump - at any cost.
15
A few short months ago, the pundits said that the Democrats had lost their way. But they failed to consider the radical Republican "top down" agenda and what the impact of that agenda would be on American voters. The Republicans are self destructing.
The simple fact is that the Republicans can not continue to legislate this way and get elected.
The simple fact is that the Republicans can not continue to legislate this way and get elected.
6
Wonderful article; it gets it right. But now what? Four to eight more years of this phony in the White House and Ryan and the extremists in the Congress. Where are the responsible, vocal, and hopeful opponents? Lost in the swamp.
2
"...a bill that began to phase out our silly employment-based system..." That's called single payer David. Then you say: "I like health savings accounts, tax credits and competitive health care markets to drive down costs." So, I don't understand what you don't like about Ryan's We Don't Care health "plan", because that's what it is. Health Savings Accounts are great if you're part of the 10% or 20% like you, who probably has "employer-based" health care that you and your anti-American friends want to eliminate. Tax credits do nothing, that's nothing for those millions of Americans with families making the median income of about $55,000 a year or less. What you "like" is supply side nonsense that you have been spouting in the Times and on PBS for years. It's cruel and anti-American not to have single payer. The best health care I've ever had is my Medicare, that like Social Security I've been paying into since I was a teenager, and it's my money, not your 1% friends, David.
14
Mr. Brooks, thank you for taking a hard line against this ridiculous and cruel bill.
That said, it bears repeating: the reason it's hard to draft a Republican plan to replace Obamacare is that Obamacare IS the Republican plan, otherwise known as Romneycare.
The real Democratic plan? Single-payer. Which just might help "address the perverse fee-for-service incentives that drive up health costs, or... "phase out our silly employment-based system, or... increase health security for the working and middle class." I know, I know. Socialistic pie-in-the-sky. Unless you live the other 32 of the 33 most developed nations in the world.
That said, it bears repeating: the reason it's hard to draft a Republican plan to replace Obamacare is that Obamacare IS the Republican plan, otherwise known as Romneycare.
The real Democratic plan? Single-payer. Which just might help "address the perverse fee-for-service incentives that drive up health costs, or... "phase out our silly employment-based system, or... increase health security for the working and middle class." I know, I know. Socialistic pie-in-the-sky. Unless you live the other 32 of the 33 most developed nations in the world.
5
"Who would have known that health care is so complicated?"
In a White House and Congress now dominated by huckster bullies and INCOMPETENTS how will our govt deal with complexities?.
Why call them "incompetents" and not "visionless and internally divided", as Mr. Brooks says.
What Brooks and others have to fess up to is that Obama was probably our greatest president ever. He took a country in a deep financial mess, fighting two unending wars, a society with many poor and sick unable to get health care, ridiculed by many around the world, even our allies. He worked with Congress and the American public to turn things around, and he was successful. No utopia, but he helped get us back on track to being a society becoming more just, economically viable, respected, and on a clear path to gradual improvement. Thoughtful, hard-working -- the values we all respect, were back on center stage.
The Repubs were elected as opponents, based on fabricated evils and on deceptive analysis. They signed up for one role -- angry opponents. They did a good job at that. And they now find themselves needing to play another role -- people in charge. Totally INCOMPETENT to govern in a democratic multicultural complex advanced society with all its quirks and varied interests and in a world of great possibilities and great challenges, they still want to just say no and to yell at someone. That just wont work. If they are not versatile enough to change their roles, then let's hire some others.
In a White House and Congress now dominated by huckster bullies and INCOMPETENTS how will our govt deal with complexities?.
Why call them "incompetents" and not "visionless and internally divided", as Mr. Brooks says.
What Brooks and others have to fess up to is that Obama was probably our greatest president ever. He took a country in a deep financial mess, fighting two unending wars, a society with many poor and sick unable to get health care, ridiculed by many around the world, even our allies. He worked with Congress and the American public to turn things around, and he was successful. No utopia, but he helped get us back on track to being a society becoming more just, economically viable, respected, and on a clear path to gradual improvement. Thoughtful, hard-working -- the values we all respect, were back on center stage.
The Repubs were elected as opponents, based on fabricated evils and on deceptive analysis. They signed up for one role -- angry opponents. They did a good job at that. And they now find themselves needing to play another role -- people in charge. Totally INCOMPETENT to govern in a democratic multicultural complex advanced society with all its quirks and varied interests and in a world of great possibilities and great challenges, they still want to just say no and to yell at someone. That just wont work. If they are not versatile enough to change their roles, then let's hire some others.
5
No punches pulled here.
You nailed it.
Trump only wants to say he 'immediately repealed 'OBAMACARE!!!'.
That would elicit resounding applause in red state diners everywhere: until, of course, those same diners learned what the repeal implied.
Republicans have spent eight years to simply saying 'No' to everything President Obama proposed.
They had no alternate plans, proposals or ideas.
Now they have to do he difficult work of actually governing: of owning what is produced.
They are the dog that finally catches the car.
Now they're stuck with the car.
You nailed it.
Trump only wants to say he 'immediately repealed 'OBAMACARE!!!'.
That would elicit resounding applause in red state diners everywhere: until, of course, those same diners learned what the repeal implied.
Republicans have spent eight years to simply saying 'No' to everything President Obama proposed.
They had no alternate plans, proposals or ideas.
Now they have to do he difficult work of actually governing: of owning what is produced.
They are the dog that finally catches the car.
Now they're stuck with the car.
3
He who troubleth his own house shall inherit the wind. - Book of Proverbs. Mr. Brooks has a keen grasp of the obvious. He forgot one thing. The Republicans don't represent the people. They represent the elite. Mr. Brooks is one of the elite. His chagrin is real, but it feels disingenuous.
4
I'm looking at the accompanying photograph of trump and instantly reminded of the photographs of Mussolini on his balcony in Rome.
4
David, you may be my favorite conservative. But you lost me at health savings accounts and tax credits. When you are among the working poor your tax bill is far less than $1000 a year, if you pay federal income tax at all. Just where does the money come from for a health savings account? Don't put so much gas in your truck to get to work? Get a third job. Conserve more electricity and don't eat so much. With all the money saved on taxes and accumulated in your health savings account, you have enough for health care. Enough to pay for one or two visits to the doctor of your choice. And you have the opportunity to choose which family member gets to go. Just don't get really sick, you can't afford it.
12
Thank you for your op-ed. As far as I am concerned, it was spot on. While I am all for single payer health care; you have some sound arguments for a decent alternative to what I would like to see, and what seems to be coming out of Congress right now. You nailed my current frustrations. Thank you.
2
The republicans had seven years to come up with an alternative to the ACA and show us that they could do better. They have failed miserably, showing just how empty their constant opposition has been.
Disgusting.
Disgusting.
7
"This bill takes the most vicious progressive stereotypes about conservatives and validates them".
Wow David, sounds a little defensive. Seems like you don't have a choir to preach to right now.
Wow David, sounds a little defensive. Seems like you don't have a choir to preach to right now.
5
Of course the Republicans should pass the AHAC. They can then market it as an ObamaCare Repeal, and their base will love it. The GOP can tell people that any problems getting health care is not because of them, it is because of ObamaCare, their plan is just coming into effect and all the problems are remnants of the horrible ObamaCare. Wait for their plan to take hold and all will be right in America. Their base will believe them and vote them back in. Getting rid of ObamaCare was why they were sent to Washington. Doing nothing spells doom for them in the primaries.
Having a marketing guy in the White House does have its advantages.
Having a marketing guy in the White House does have its advantages.
2
You opposed Obama care, you like health savings accounts, tax credits and competitive health care markets to drive down costs. In other words, you like every single irrelevant Republican healthcare dodge which has been proven not to work. Read carefully now, David, you are apparently even more out of touch with the reality of middle and lower income Americans' lives than even I thought, if you believe those flim-flams would work. A "healthcare savings account" is totally and absolutely worthless to a lower income or middle class American. They might work for those inside the beltway who have safe, negotiated healthcare packages, but, now get this, most Americans do not. Healthcare savings accounts have stupid limitations: no lower or middle income American can get enough money into that damned account to cover anything of any value. Virtually any doctor's office visit or one single emergency room visit, with no other charges beyond the ER charge (by the way, there is no such thing), will wipe out a year's worth of healthcare savings account accumulations in the merest moments. And, I know this will come as a big shock to you and your ilk, Only a small percentage of Americans have an income such that tax credits have any relevance whatsoever. But that's Republicanism for you - always and forever, out of touch with the realities of American life. Oh, and in case I forget to remind you again, trickle-down economics does not work. Never has. Never will.
12
Dear David,
I know you must feel isolated, alone , pining for a republican party that no longer exists. Your party is so empty they call Paul Ryan a "policy wonk" when he can't craft a single piece of legislation to benefit the country . Come over to our side, the democrats.
We have major problems too given the impact of corporate money on politicians. But we can govern and craft solutions and aim for the best qualities of our nation. You've got Trump.
Sincerely your brother,
John
I know you must feel isolated, alone , pining for a republican party that no longer exists. Your party is so empty they call Paul Ryan a "policy wonk" when he can't craft a single piece of legislation to benefit the country . Come over to our side, the democrats.
We have major problems too given the impact of corporate money on politicians. But we can govern and craft solutions and aim for the best qualities of our nation. You've got Trump.
Sincerely your brother,
John
10
This bill should really be called,"Whatever It Takes Bill" because that is what it seems to have been the goal. No real policy-making going on. No major benefits for the majority of Americans.
When someone shows you who they are , believe them. This is what the Republican Party has come to. Take them at their word and vote accordingly in 2018.
Linda Selvia
When someone shows you who they are , believe them. This is what the Republican Party has come to. Take them at their word and vote accordingly in 2018.
Linda Selvia
7
Mr. Brooks,
Well done, to correct the overused citation from Governor Winthrop's homily on board the Arabella, but the correction is mistaken: it is not a vision, but a warning, a reference to St. Matthew: "A city on a hill cannot be hid."
For its origins in modern American politics, which go back to Arthur Schlesinger, Jack Kennedy. and his speech at Faneuil Hall in 1961, see my book "On the Demilitarization of American Diplomacy" (Palgrave Macmillan, 2014), a Niehbuhrian defense of our much abused diplomatic institutions.
Laurence Pope
Well done, to correct the overused citation from Governor Winthrop's homily on board the Arabella, but the correction is mistaken: it is not a vision, but a warning, a reference to St. Matthew: "A city on a hill cannot be hid."
For its origins in modern American politics, which go back to Arthur Schlesinger, Jack Kennedy. and his speech at Faneuil Hall in 1961, see my book "On the Demilitarization of American Diplomacy" (Palgrave Macmillan, 2014), a Niehbuhrian defense of our much abused diplomatic institutions.
Laurence Pope
Brooks, why don't you just admit the truth? The GOP's hysterical opposition to Obamacare never had a thing to do with the merits of the law. It had to do with handing a Democratic President a defeat, and members of Congress admitted exactly as much, gloating that "It will be his Waterloo. It will break him." After it turned out to be their own Waterloo instead, they never forgave Obama, and never gave up trying to reverse the outcome, but never once in 7 years gave a moment's thought to actually crafting an alternative, because, as you correctly, FINALLY notice, they didn't care. You inadvertently told an important truth when you recommended " a bill that began to phase out our silly employment-based system." Guess how you do that, pal? National health, a single-payer, government-run public option.
382
The game in Washington is to cloak what you are doing and put on a big show of hard work and concern about the voters. Rarely do legislators in the House and Senate stand naked as to their objectives, as low as they might be. This is an exception. The Republicans in the House have revealed themselves in a way they never intended and from which they would normally scurry like rats with a light suddenly switched on in a dark room. Caught!
They have dedicated themselves to the proposition that government can't, and shouldn't try, to help people. "Providing for the general welfare", in their view, is merely about protecting the wealth of the few from the constant danger of taxes. They are hired and paid to take this position by America's mega-rich and their nearby neighbors, the well off, the comfortable, in their home districts. The wealthy not only expect a return on their investment, they demand it.
The Republicans are driving toward a brick wall at 80 mph. They wanted to show fealty to their own relentless, unending campaign against Obamacare. After having voted to repeal it 1,300 times (or was it 1,400?), glory be, with the majority and a willing president, they had the opportunity to repeal it for real.
They should quit while they are behind. There can be no decent replacement because they are locked into a position of opposing govt., period, and their so called Freedom Caucus is locked in to opposing everything.
They have dedicated themselves to the proposition that government can't, and shouldn't try, to help people. "Providing for the general welfare", in their view, is merely about protecting the wealth of the few from the constant danger of taxes. They are hired and paid to take this position by America's mega-rich and their nearby neighbors, the well off, the comfortable, in their home districts. The wealthy not only expect a return on their investment, they demand it.
The Republicans are driving toward a brick wall at 80 mph. They wanted to show fealty to their own relentless, unending campaign against Obamacare. After having voted to repeal it 1,300 times (or was it 1,400?), glory be, with the majority and a willing president, they had the opportunity to repeal it for real.
They should quit while they are behind. There can be no decent replacement because they are locked into a position of opposing govt., period, and their so called Freedom Caucus is locked in to opposing everything.
203
Be realistic. People who can't earn enough to save can't create health savings. Healt insurers don't compete, they collude. The insurers have no redeeming characteristics. If we truly want to cover everyone, we need Medicare for all. It's simple, straightforward, with very low administrative cost. Marketing doesn't work People need care.
John H. Sadler, MD
John H. Sadler, MD
28
"...[L]and speed record for forgetting where you come from?" No, it's Republicans doing, yet again, what they have always promised and intended to do: benefit the .1% through regressive tax policies and wage class warfare against the middle and lower classes, all the while lying and spinning, ideological blinders firmly in place. They know where they come from and who sent them there, and it's not some populist movement.
14
Conservative House Republicans (and the Koch Bros.) - with support from the Liar-in-Chief - demand that health plans end requirements that provide basic benefits like maternity care, emergency services, mental health and wellness visits. Let's review:
- No birth control coverage for women
- No abortion coverage
- No maternity benefits (i.e., no pre- and post-natal care, miscarriage management)
- No emergency visit coverage for pregnancy related or fetal distress emergencies (each year an estimated 1,200 women in the US suffer complications during pregnancy or childbirth that prove fatal and 60,000 suffer complications that are near-fatal)
Let's review Trumpcare again, a different way:
- Women's reproductive coverage: Zilch.
- Men's reproductive coverage: Viagra, vasectomies and prostate screening.
I see a pattern here and it's called misogyny.
There's also a larger pattern: the reliably plutocratic-serving Republicans redistributing wealth upwards by giving a tax decrease, via repeal of the ACA, to the already obscenely wealthy.
And let's not forget the best - no wellness visits or emergency coverage will lead many to financial hardship, massive debt and the degradation of American's health. So nice!
2018 and impeachment can't come soon enough, I'm plum out of outrage and disgust at these deplorable, despicable sociopaths (I'm also running out of derogatory adjectives).
- No birth control coverage for women
- No abortion coverage
- No maternity benefits (i.e., no pre- and post-natal care, miscarriage management)
- No emergency visit coverage for pregnancy related or fetal distress emergencies (each year an estimated 1,200 women in the US suffer complications during pregnancy or childbirth that prove fatal and 60,000 suffer complications that are near-fatal)
Let's review Trumpcare again, a different way:
- Women's reproductive coverage: Zilch.
- Men's reproductive coverage: Viagra, vasectomies and prostate screening.
I see a pattern here and it's called misogyny.
There's also a larger pattern: the reliably plutocratic-serving Republicans redistributing wealth upwards by giving a tax decrease, via repeal of the ACA, to the already obscenely wealthy.
And let's not forget the best - no wellness visits or emergency coverage will lead many to financial hardship, massive debt and the degradation of American's health. So nice!
2018 and impeachment can't come soon enough, I'm plum out of outrage and disgust at these deplorable, despicable sociopaths (I'm also running out of derogatory adjectives).
38
Mr. Brooks, you don't get it either. Most Americans will not benefit from tax credits. Most Americans will not be able to save for Health Savings Accounts. Most Americans will not understand how to use a Health Savings Accounts. You are also an elitist with little understanding of our population.
38
Yes it's true, Republicans can't govern because they are intellectually and morally compromised. Try challenging the extreme elements of your party and the radical right-wing infotainment complex vs lying and misleading your constituents.
Grow up, stick your neck out and be a responsible leader. That's a true patriot.
Grow up, stick your neck out and be a responsible leader. That's a true patriot.
Discussing the underlying 'ideas' and goals underlying the GOP health care bill is akin to critiquing Nero's choice of music and playing style while Rome burns. Vapid? Not the first descriptive that comes to mind.
11
Brooks continues to drift, unhinged. He's unable to give up on the GOP as it moves away from everything he purports to stand for. He's unable to give up on "principles" even as these are revealed (including by him) as fig leaves for taking from the poor and giving to the rich. He somehow simultaneously says the government should move employers away from being the providers of health insurance and it should unleash "competitive health care markets". You can't have it both ways and neither is a solution.
Time to hang it up, Brooks, your "insights" are no longer part of the discussion, and your worldview is obsolete.
Time to hang it up, Brooks, your "insights" are no longer part of the discussion, and your worldview is obsolete.
13
What? Do they really have a marketing guy in charge of the factory? A real Marketing man sells products, services, or ideas based on his potential customers' wants or needs. Marketing research or polls tell to a real Marketing person what he has to do in order to succeed and be a market leader.
Sniff, sniff.
Sniff, sniff.
4
"I opposed Obamacare. I like health savings accounts, tax credits and competitive health care markets to drive down costs. But these free-market reforms have to be funded in a way..."
Good to you know you like these ideas. Actual health policy experts think they're completely ineffective as a solution. But good to know what DB likes.
Good to you know you like these ideas. Actual health policy experts think they're completely ineffective as a solution. But good to know what DB likes.
We are locked inside a car driven at breakneck speed by a drunken driver and now we are learning that the health insurance we will need to cover the accident we will have has been canceled. Nice going, you sadistic Republicans and lily-livered Democrats. I won't forget you, come November.
18
While all these right wing critiques are right as far as they go, they miss the essential inanity of the Republican promises. The promise for "great health care for everybody" with both lower taxes and lower fees was so preposterous Trump himself once ended a riff with "can you believe it?" As if to ask "how stupid are you people?"
On health savings accounts this also seems ridiculous. The essentially subsidizes medical costs according to the tax rate schedule - the more you pay in taxes the greater the subsidy. What on earth is the argument for that? The most obvious problem is it provides the least benefit to those who need it most and who are most disproportionately sick (poor people with low taxes). It is like a kind of sick Republican joke: "Go ahead and have progressive taxes that benefit the poor, we rich people will just get fatter benefits for our healthcare! Har har!"
On health savings accounts this also seems ridiculous. The essentially subsidizes medical costs according to the tax rate schedule - the more you pay in taxes the greater the subsidy. What on earth is the argument for that? The most obvious problem is it provides the least benefit to those who need it most and who are most disproportionately sick (poor people with low taxes). It is like a kind of sick Republican joke: "Go ahead and have progressive taxes that benefit the poor, we rich people will just get fatter benefits for our healthcare! Har har!"
12
Although Trump won the election, each and every day, the blind allegiance to Party within the Republican Caucus is becoming more staggering. Voters are tired of stupid. Imperfect, but affordable health care has been available for millions of Americans for the last seven years, in most states. Republicans enjoyed stomping their feet over sixty times to repeal this care. These empty tantrums brought inept and easy power to the House floor. It took Trump a while, but he has figured out the long game. There is no win in this deal. However, if this bill passes, and Representative Ryan's sadistic smiles return, will Trump win sounding another alarm for more tax breaks for the rich? I don't think so. Twenty-four million Americans may lose their health, but not their minds.
8
What the push by Ryan and 45 for this Trumpcare has solidified for me is that Republicans don't give a damn about working to bring a better healthcare plan to Americans. The goal, the only goal seems to be to "stick it to President Obama"..by repealing the ACA. Not caring that it will throw millions of Americans off healthcare, while giving tax breaks to the richest Americans.
Trumpcare is a Tax Break Bill not a healthcare bill.
When will the United States of America, the richest nation in the world, join the rest of the Industrialized nations and give its citizens Universal Healthcare? When will finally realize that giving citizens healthcare is a moral imperative, that makes a nation stronger?
When will we finally stop putting the Free Market, which has failed miserably when it comes to health care, a priority over the health of its citizens?
And BTW, the only "death panels" in this country is the Freedom Caucus..and their desire to take away all government subsidies for healthcare.
Trumpcare is a Tax Break Bill not a healthcare bill.
When will the United States of America, the richest nation in the world, join the rest of the Industrialized nations and give its citizens Universal Healthcare? When will finally realize that giving citizens healthcare is a moral imperative, that makes a nation stronger?
When will we finally stop putting the Free Market, which has failed miserably when it comes to health care, a priority over the health of its citizens?
And BTW, the only "death panels" in this country is the Freedom Caucus..and their desire to take away all government subsidies for healthcare.
17
Donald Trump claims to be a strong leader pledging to make America equally strong. What's becoming clear, however, is that whatever strength he has is limited to the volume of his tweets, not their substance or that of his policies.
By all measures, Trump appears to be driven primarily by simplistic and largely antagonistic symbolism and marketing hype. That's what made him famous for being famous. What's not apparent is that he has any interest in details, any knowledge of governing, any propensity to learn, or any sense of history. Combined with his aberrant tendency to oversimplify complex issues, Trump is way out of his depth.
Barring unforeseen events, Trump may well go down as the owner of a hurriedly cobbled together, insensitive and failed health care reform effort, ironically just like his nemesis, Hillary Clinton did early in her husband's presidency. Were it a building, Trump's "Repeal Obamacare" effort could well collapse into big, loud heap of rubble and dust. Can you spell "loser?"
By all measures, Trump appears to be driven primarily by simplistic and largely antagonistic symbolism and marketing hype. That's what made him famous for being famous. What's not apparent is that he has any interest in details, any knowledge of governing, any propensity to learn, or any sense of history. Combined with his aberrant tendency to oversimplify complex issues, Trump is way out of his depth.
Barring unforeseen events, Trump may well go down as the owner of a hurriedly cobbled together, insensitive and failed health care reform effort, ironically just like his nemesis, Hillary Clinton did early in her husband's presidency. Were it a building, Trump's "Repeal Obamacare" effort could well collapse into big, loud heap of rubble and dust. Can you spell "loser?"
7
Progress!
Twice in the same year I must agree with at least some of what you have written.
Twice in the same year I must agree with at least some of what you have written.
5
The Republicans throughout the years have gradually reduced themselves to one ideology and one grand overarching vision: enriching the rich.
That's all they've be able to come up with for the last hundred years.
You can throw all the brainwashing in the world at voters with the tabloid trash of Fox and the surreal alternate universes of Limbaugh and the tweeting lies of Trump, but the reality is: Republicans have no viable plan to improve the lives of Americans. They live in a myopic fantasy world devoid of any rational intellect or self-reflection.
BUILD upon and IMPROVE the plan that Obama came up with, you fools!
That's all they've be able to come up with for the last hundred years.
You can throw all the brainwashing in the world at voters with the tabloid trash of Fox and the surreal alternate universes of Limbaugh and the tweeting lies of Trump, but the reality is: Republicans have no viable plan to improve the lives of Americans. They live in a myopic fantasy world devoid of any rational intellect or self-reflection.
BUILD upon and IMPROVE the plan that Obama came up with, you fools!
20
A clear-eyed look at how Trump and the Republicans in the House have gotten themselves into this mess, fashioning a bill that Is inhumane, incohérent, and politically self-inflicted wound. Could not happen to nicer guys.
Bravo, Mr. Brooks!
Bravo, Mr. Brooks!
8
Good, useful column.
It does beg the question, just who the heck is to blame for Trump? Is it the Republican voters who installed him, or Putin and his Manfortian henchmen who tricked the voters into seeing him as a savior just because he was able to define the problem? Was it the Democrats and Hillary Clinton? The FBI and Comey? The Russian hack Assange?
Time will tell, but count me as one American who is totally hopeful Trump ends up as Yanukovych did in Ukraine. And after that, we sail American Naval Vessels into the Black Sea to confront our true enemy, Putin.
We are at war, that is clear. McCain, unfortunately was right.
Hugh Massengill, Eugene Oregon
It does beg the question, just who the heck is to blame for Trump? Is it the Republican voters who installed him, or Putin and his Manfortian henchmen who tricked the voters into seeing him as a savior just because he was able to define the problem? Was it the Democrats and Hillary Clinton? The FBI and Comey? The Russian hack Assange?
Time will tell, but count me as one American who is totally hopeful Trump ends up as Yanukovych did in Ukraine. And after that, we sail American Naval Vessels into the Black Sea to confront our true enemy, Putin.
We are at war, that is clear. McCain, unfortunately was right.
Hugh Massengill, Eugene Oregon
5
Stop the presses! David Brooks has awakened!
Now you have to get Nunes to admit that we need an independent prosecutor.
Now you have to get Nunes to admit that we need an independent prosecutor.
4
And this is just about getting the legislation through the House. If it passes, it would need to go to the Senate, of course.
Once it gets there, where is Senator Chuck "No one's gonna pull the plug on grandma" Grassley of Iowa?
Oh, right, he's too busy trying to jam Neil Gorsuch down our throats.
Gee, thanks, "conservatives." You've been doing on heckuva job.
Once it gets there, where is Senator Chuck "No one's gonna pull the plug on grandma" Grassley of Iowa?
Oh, right, he's too busy trying to jam Neil Gorsuch down our throats.
Gee, thanks, "conservatives." You've been doing on heckuva job.
7
I was listing to someone from the "Freedom Caucus" talk about moving people into high risk pools so that insurance rates would go down. After my diagnosis of breast cancer at age 44 my self-insurance rates skyrocket to $2000 per month for an 80/20 plan with $5000 deductible. I checked into the high risk pool thinking it might be cheaper. Wrong. It would have cost me $3000 per month or $36,000 per year. I would have preferred to die than struggle with that kind of cost. The reality is that we need a single-payer system that insures all or we'll become the third-world country some already think we are.
17
Right wing media has brainwashed two generations of conservatives. They now vote to burn their own houses down in the guise of Freedumb.
28
Perhaps the only way to defeat a terrible bill is to attach Trump's name and sell it to the country as terrible. Trumpcare will kill you! Trumpcare is Chumpcare! Who needs Death panels when they have Trumpcare?
We can make sure that everyone knows it is terrible. That even Angela Merkel has a better system. That Obamacare helped a lot of people, but Trumpcare is terrible! A disaster! Sad! That Paul Ryan pulled the wool over Trump's eyes, and is turning Trump's name to mud. That Ryan wins, and makes Trump look like a loser with this bill.
Meanwhile, we can all make our Senators, who are not gerrymandered, know that we object to just letting poor people sink under, and imperiling our women - many of whom are wives and daughters, just in case they are of a mind to not recognize women as valuable constituents.
We can make sure that everyone knows it is terrible. That even Angela Merkel has a better system. That Obamacare helped a lot of people, but Trumpcare is terrible! A disaster! Sad! That Paul Ryan pulled the wool over Trump's eyes, and is turning Trump's name to mud. That Ryan wins, and makes Trump look like a loser with this bill.
Meanwhile, we can all make our Senators, who are not gerrymandered, know that we object to just letting poor people sink under, and imperiling our women - many of whom are wives and daughters, just in case they are of a mind to not recognize women as valuable constituents.
13
Whether this cruel and mean program will pass the House and the Senate I cannot guess, but the Republicans are are playing another game as well. Obamacare, legal abortion, and gun rights are the three rails of Republican voter appeal. Actually repealing/replacing/whatever Obamacare would eliminate this mother lode of votes. So what's the rush?
Harriet
Harriet
4
Oh, Please, let them govern!!! 7 years in the works and this is what we have? Really!! Ryan, this is all you could come up with; no mammograms (which saved my wife's life at 44 years old), no wellness visits (which my entire family uses), no mental health coverage (which my daughter uses), no ER visits? Really? Seriously? All to just Repeal and Replace? 7 years and this is what you brought to the table? Blind hatred has delivered you nothing but empty promises, no foresight, and NOTHING! Now they will know how it feels to lose! The funny thing is, Trump has turned on you too, this will be your fault just like that 1st special ops invasion under Trump's watch. Not his fault, the military's fault! He'll be a good partner for the next tax fight too, and budget fight, and infrastructure fight!
457
Well said. Thank you.
2
Dear Mr. Brooks,
I would point out that this is the same crowd YOU supported in the eight years of the Obama Administration.
I would also point out that Mr. Trump was the nominee of YOUR party and is now the president and, as far as the last time anyone checked the mottled striping on his belly, a REPUBLICAN.
Nothing has changed the dynamic. How many times did the crowd YOU support endlessly try to vote to repeal ACA? Not a peep from you on that score.
So reap what you helped sow, brother, and stop hiding behind a phony "intellectual" stand to try to cover your last eight years of, how do I put this, oh yes, "fake news" about these clowns!
I would point out that this is the same crowd YOU supported in the eight years of the Obama Administration.
I would also point out that Mr. Trump was the nominee of YOUR party and is now the president and, as far as the last time anyone checked the mottled striping on his belly, a REPUBLICAN.
Nothing has changed the dynamic. How many times did the crowd YOU support endlessly try to vote to repeal ACA? Not a peep from you on that score.
So reap what you helped sow, brother, and stop hiding behind a phony "intellectual" stand to try to cover your last eight years of, how do I put this, oh yes, "fake news" about these clowns!
12
Amen, David.
4
David Brooks speaks for the common man!!
Why it took you so long is the real story. 'Bout time you spoke for the people instead of the wealthy koch-style republican.
Why it took you so long is the real story. 'Bout time you spoke for the people instead of the wealthy koch-style republican.
8
Well spoken Sir. Mr. Brooks, . . Davd, I could have said this no better. Well done indeed.
1
Remind me David: what party do you typically support? And, considering how predictable the current situation is, how hard did you advocate for Hillary?
More empty words from an empty columnist who bemoans the bed he helped make...
More empty words from an empty columnist who bemoans the bed he helped make...
13
Trump has no moral compass....no true North. He has no vision or coherent thoughts. His narcissistic personality knows no bounds. His entire life has been a series of amoral and reckless negotiations. Three wives, numerous girlfriends and misogynistic tendencies that would shame anyone else?....all meaningless in his universe. Pro life or pro choice?....what day of the political calendar is it? Healthcare for all or draconian cuts for the poor and elderly?....whatever sells best today. One state solution for Israel or two?....um, remind me, who is visiting White House today? My business is losing money?....declare bankruptcy or sue someone. How could we do this to America? Better yet, let's all agree we need to fix it and fast....2018 and 2020 are just around the corner.
25
There were several decent things that needed to be said and you missed:
- Single payer is the improvement to the ACA. Like Europe.
(Obamacare is not perfect. You were against it. But your blahblah to replace it is ... blahblah)
- Your attack on Trump is OK. Not very original, and we don't learn anything new. But then you let an indecent liar get away waith murder. Yes, sir. You don't mention that there is a despicable accomplice named Paul Ryan.
I am a practising catholic and I swear to God they would have to call the police to take me out of church if Ryan attended mass there.
Conclusion and free advice to you: DO READ THE N.Y.TIMES. There is a guy there you don't like who could teach you a thing or two about a lot ot of things. His first name is Paul, too.
- Single payer is the improvement to the ACA. Like Europe.
(Obamacare is not perfect. You were against it. But your blahblah to replace it is ... blahblah)
- Your attack on Trump is OK. Not very original, and we don't learn anything new. But then you let an indecent liar get away waith murder. Yes, sir. You don't mention that there is a despicable accomplice named Paul Ryan.
I am a practising catholic and I swear to God they would have to call the police to take me out of church if Ryan attended mass there.
Conclusion and free advice to you: DO READ THE N.Y.TIMES. There is a guy there you don't like who could teach you a thing or two about a lot ot of things. His first name is Paul, too.
10
How can you keep getting it wrong NYT's? The majority bill will pass.
Hell has frozen over, in early spring. Sir, I agree with you. 100%. !!!!
6
Gee, Mr. Brooks, maybe the Republican health bill would pass if everyone would just let Bannon be Bannon.
9
Dorothy, you missed this OZ character........the Wicked Witch's soulless partner .......he takes from the poor, gives to the rich - denies affordable health care for the less fortunate - loves oil pipe lines on other people's condemned property - confuses gaudy glitz with class.......on second thought maybe he fits better as a depraved lead in Citizen Kane
13
"This bill takes the most vicious progressive stereotypes about conservatives and validates them" -- because they're TRUE, Mr. Brooks.
Wake up.
Wake up.
26
This new plan was not crafted by elites in Washington but by the shareholders and CEO'S of the insurance monopolies. They made the decision to pull out of markets to sink ACA. Watch...if ACA remains they will jump back in!
13
I am wondering what people expected from a so-called man who imitates handicapped people and asks a crowd 'don't you just want to punch him in the face?' referring to a detractor.
37
David Brooks nails it. If only the US Congress would listen to him. ..
16
Republicans: Once you've lost David Brooks, you know you're in trouble. Nuff said.
28
"But with this bill the Republican leadership sets an all-time new land speed record for forgetting where you came from."
And forgetting who put you where you are and why.
Yes, the stereotype of the vicious, scheming GOP has been validated.
The GOP had 7 years to come up with a plan to repeal the ACA. Seven years and this is what they came up with? Trump/Ryancare is not about healthcare it's about a trophy for the GOP "leadership" and most importantly for Trump. Where is the debate, the ideas, the critical thinking necessary to make a policy that addresses real issues, the real flaws of ACA which President Obama admits can be improved? Isn't that what our representatives are supposed to do?
And forgetting who put you where you are and why.
Yes, the stereotype of the vicious, scheming GOP has been validated.
The GOP had 7 years to come up with a plan to repeal the ACA. Seven years and this is what they came up with? Trump/Ryancare is not about healthcare it's about a trophy for the GOP "leadership" and most importantly for Trump. Where is the debate, the ideas, the critical thinking necessary to make a policy that addresses real issues, the real flaws of ACA which President Obama admits can be improved? Isn't that what our representatives are supposed to do?
38
I have a silver plan and am in that small slice of the insured whose premiums have doubled since I enrolled, but I still strongly support the ACA because of the strong federal regulations embedded in the law. My insurance is expensive, but I can rely upon it. I do not trust the state regulators here in Alabama; they are political tools of the insurance companies. Seriously. Alabama's state government is so weak that at it has no chance of defying large corporations and the politicians. The Fed regulators are beacons of enlightened strength and efficiency in comparison.
291
Mr. Brooks correctly identifies one source of this fiasco in Trump's background as a marketer, not a producer. A salesman tends to identify success with the quantity of the product snapped up by consumers, not with the quality of the merchandise. Trump has repeatedly touted the level of his wealth as proof of his success and as a measuring stick of his business acumen.
While the mogul of Trump tower robotically proclaimed the superior quality of his steaks and ties, he always stressed the high income generated by sales as the true mark of his genius. His focus on optics rather than substance in the struggle for legislation, therefore, simply reflects his definition of "achievement." I strongly suspect that, if congress had passed a liberal bill with a single payer option, the president would have declared success and solemnly presented the measure to the country as proof that his visage belonged on Mt. Rushmore.
Trump's indifference to any coherent ideology might have made him a minimally competent president. Paired with a Congress dominated by moderate Republicans (extinct species), the administration might have crafted a healthcare bill that could have modestly improved on Obamacare. The Republicans might have worked with their Democratic colleagues to fashion an immigration bill that improved border security while also achieving a humane solution to the problem of undocumented aliens.
But that would require a GOP that welcomed compromise.
While the mogul of Trump tower robotically proclaimed the superior quality of his steaks and ties, he always stressed the high income generated by sales as the true mark of his genius. His focus on optics rather than substance in the struggle for legislation, therefore, simply reflects his definition of "achievement." I strongly suspect that, if congress had passed a liberal bill with a single payer option, the president would have declared success and solemnly presented the measure to the country as proof that his visage belonged on Mt. Rushmore.
Trump's indifference to any coherent ideology might have made him a minimally competent president. Paired with a Congress dominated by moderate Republicans (extinct species), the administration might have crafted a healthcare bill that could have modestly improved on Obamacare. The Republicans might have worked with their Democratic colleagues to fashion an immigration bill that improved border security while also achieving a humane solution to the problem of undocumented aliens.
But that would require a GOP that welcomed compromise.
16
Spot on, Mr. Brooks. What kind of client would instruct his negotiator to go consummate a deal -- any deal -- for the sheer sake (perhaps thrill) of making one? Only a fool, or one that has no concern for his own well-being.
Remember, this is the administration that has such a juvenile predisposition to undo the work of its predecessor that it rescinded an order compelling brokers to act in their client's best interest. Seems like pretty clear evidence of the absence of any professional principals or moral compass.
We've moved from the swamp to the dark alleys of streetgang ethos and braggadocio. All us suckers are going to get for the next four years is rule by ego and life in a walled compound.
Remember, this is the administration that has such a juvenile predisposition to undo the work of its predecessor that it rescinded an order compelling brokers to act in their client's best interest. Seems like pretty clear evidence of the absence of any professional principals or moral compass.
We've moved from the swamp to the dark alleys of streetgang ethos and braggadocio. All us suckers are going to get for the next four years is rule by ego and life in a walled compound.
14
"So the Republicans have the politics driving the substance, not the other way around."
Where have you been, David? During the election campaign, were you so scornful and dismissive of Trump (justifiably so, btw) that you paid no attention to what he was doing? He Foxified the political campaign. He didn't lie like Hillary; he just made stuff up, like Fox News. And once you go fact-free, of course "politics driv[es] the substance" because there is no substance without facts. They what substance is made from.
Where have you been, David? During the election campaign, were you so scornful and dismissive of Trump (justifiably so, btw) that you paid no attention to what he was doing? He Foxified the political campaign. He didn't lie like Hillary; he just made stuff up, like Fox News. And once you go fact-free, of course "politics driv[es] the substance" because there is no substance without facts. They what substance is made from.
8
Mr. Brooks,
I concur with your statement, "His lobbying efforts for the legislation were substance-free." That is exactly why it is baffling that millions of individuals who are critical thinkers voted for him. The same lack of substance is how he ran his campaign. He received votes based on propaganda versus policy so there are no surprises here. He and his counterparts are a ready, aim, fire administration and while the consequences of his executive orders, actions, etc....may not be immediately seen, we all will feel the negative repercussions later. The health care bill has been done the same way.
I will never understand the 2016 election. We had a well qualified Female candidate that had policies we could read and digest. On the other hand, we had a wealthy businessman who lacked government experience with no clear policies...just a bunch of pontificating and propaganda. Both candidates had issues, but it was clear which one would have been able to execute policies without the consistent confusion.
Yes the election is far from over and I'm over it, but the fact that millions of people are tolerant of this egregious behavior from one man and had play dolls of our other president hanging from a tree, reveals that our country is morally sick and negates to understand that when you sow seeds of destruction for other people, it comes back. Irrespective of race or political affiliation, nobody should be satisfied with this ad hoc, loosey goosey governing.
I concur with your statement, "His lobbying efforts for the legislation were substance-free." That is exactly why it is baffling that millions of individuals who are critical thinkers voted for him. The same lack of substance is how he ran his campaign. He received votes based on propaganda versus policy so there are no surprises here. He and his counterparts are a ready, aim, fire administration and while the consequences of his executive orders, actions, etc....may not be immediately seen, we all will feel the negative repercussions later. The health care bill has been done the same way.
I will never understand the 2016 election. We had a well qualified Female candidate that had policies we could read and digest. On the other hand, we had a wealthy businessman who lacked government experience with no clear policies...just a bunch of pontificating and propaganda. Both candidates had issues, but it was clear which one would have been able to execute policies without the consistent confusion.
Yes the election is far from over and I'm over it, but the fact that millions of people are tolerant of this egregious behavior from one man and had play dolls of our other president hanging from a tree, reveals that our country is morally sick and negates to understand that when you sow seeds of destruction for other people, it comes back. Irrespective of race or political affiliation, nobody should be satisfied with this ad hoc, loosey goosey governing.
11
"The new elite is worse than the old elite — and certainly more vapid."
It certainly is a good thing Donald Trump is so loud, aggressive and energetic. That's what it has taken to get an inkling of sense into the skull of David Brooks.
It certainly is a good thing Donald Trump is so loud, aggressive and energetic. That's what it has taken to get an inkling of sense into the skull of David Brooks.
7
"the vapidity of his narcissisim." Well said.
2
I don't suspect Trump of conceptualising this consciously, as an id-forward ego-trumpet, superego-hating kind of guy
(you know, to paraphrase Freud).
But this I think underlies, in the deepest, most simian grilled morsel of his brain, his hopes and dreams.
I am ahead of y'all by a few hours from where I write, so I may be proved BIGLY wrong. Because, whichever way the possible vote swings, Trump will nonetheless claim MASSIVE VICTORY!
Yet I suspect that in his "insconscience professionnelle", as we say here in France, if we really want to humiliate someone, he is likely hoping that the Namurrican Health Care No-Plan, or whatever it is called, does NOT get the votes it needs to pass.
That would free him from much pressure from the remnants and vestiges of the Tea Party, behind which he might have aligned himself at times in the past but still: a passel of riff-raff he clearly hates and despises, being the Philistine rich success story he is.
Talk about, "...yearning to breathe free!"
Not to mention it would leave the improved health care of millions in provisional abeyance, improved yet not guaranteed---a dealmaker's El Dorado.
Incidentally, David, please stop littering your columns with verbal pollution like, "... I like health savings accounts, tax credits and competitive health care markets to drive down costs. But these free-market reforms have to be funded in a way to serve the least among us, not the most..."
"Competitive health care," give me a break! Okay?
(you know, to paraphrase Freud).
But this I think underlies, in the deepest, most simian grilled morsel of his brain, his hopes and dreams.
I am ahead of y'all by a few hours from where I write, so I may be proved BIGLY wrong. Because, whichever way the possible vote swings, Trump will nonetheless claim MASSIVE VICTORY!
Yet I suspect that in his "insconscience professionnelle", as we say here in France, if we really want to humiliate someone, he is likely hoping that the Namurrican Health Care No-Plan, or whatever it is called, does NOT get the votes it needs to pass.
That would free him from much pressure from the remnants and vestiges of the Tea Party, behind which he might have aligned himself at times in the past but still: a passel of riff-raff he clearly hates and despises, being the Philistine rich success story he is.
Talk about, "...yearning to breathe free!"
Not to mention it would leave the improved health care of millions in provisional abeyance, improved yet not guaranteed---a dealmaker's El Dorado.
Incidentally, David, please stop littering your columns with verbal pollution like, "... I like health savings accounts, tax credits and competitive health care markets to drive down costs. But these free-market reforms have to be funded in a way to serve the least among us, not the most..."
"Competitive health care," give me a break! Okay?
7
Some moderate Republicans are beginning to both smell and write about the putrid stench wafting from current conservative ideology. Welcome. The rest of us have been nauseated and vomiting for years now.
David, you seem like a caring man. I wish for you and your offspring that you could stop waiting for policies that fit your ideology and start supporting ones that actually improve people's lives. You opposed Obamacare. You were waiting for "health savings account, tax credits, and competitive healthcare markets" that will never happen instead of supporting different policies that you now seem to believe have made a significant improvement. Are you concerned about climate change? If you and others like you continue to vote Republican, your grandchildren will most certainly suffer from its devastation. You're waiting for free market solutions to income inequality that will also never materialize. The left has workable solutions for that, too, that also don't fit your ideology but will significantly improve the situation. Why not support them rather than wait?
You made the mistake of waiting for your ideals with Obamacare and it is exploding in your face. Don't make the same mistake with other issues that, if not addressed, will be even more devastating.
David, you seem like a caring man. I wish for you and your offspring that you could stop waiting for policies that fit your ideology and start supporting ones that actually improve people's lives. You opposed Obamacare. You were waiting for "health savings account, tax credits, and competitive healthcare markets" that will never happen instead of supporting different policies that you now seem to believe have made a significant improvement. Are you concerned about climate change? If you and others like you continue to vote Republican, your grandchildren will most certainly suffer from its devastation. You're waiting for free market solutions to income inequality that will also never materialize. The left has workable solutions for that, too, that also don't fit your ideology but will significantly improve the situation. Why not support them rather than wait?
You made the mistake of waiting for your ideals with Obamacare and it is exploding in your face. Don't make the same mistake with other issues that, if not addressed, will be even more devastating.
7
I continue to pretend to be amazed that Republicans make no mention of how their legislation will hurt ordinary Americans. Without a seeming hint of concern they are pushing this bill that benefits no one other than millionaires. In a perverse way, I am rooting for its passage, so that it may be hung around their necks for all to see. Ryan can then tour his district with his PowerPoint, Freedom Caucus membership can do likewise. Tuesday Morning moderates likewise can make similar forays into home country with this stinker to defend.
Trump who will claim victory no matter the outcome, will move on via Twitter and fake news, will never lose his base. To be sure, he is in for the short haul.
Let there be a vote. Once and for all.
Trump who will claim victory no matter the outcome, will move on via Twitter and fake news, will never lose his base. To be sure, he is in for the short haul.
Let there be a vote. Once and for all.
2
This is YOUR party, Brooks. This is what 30 years of the dumbing down of the American electorate (thanks to Fox and hate radio) have done. You own it. This is your republican party. The hate filled, racist, xenophobic, homophobic and the over the top misogyny is all yours. Quit writing like you don't own it, like you're different from it all, you're not. This is yours. Hateful and incredibly ugly. Disgusting.
6
It is even more clear that the Democrats and Independents are unsure of themselves in how to combat this internal terror and the current President Terrorist. These formidable groups are nowhere to be seen. They are not proactive.
The Womens' March took to the streets!!
Dems and Indies have left the counterpunching to the media. Who are doing a Herculean job of fact based reporting, calling out the bullying administration.
The greed factor is at play again. America is being ruled by the top 1 %. Working class folks thought Trump would "have their backs". Look at Trump now, folks.
I will not support the Dems with my cash until they bareknuckle these liars.
The Womens' March took to the streets!!
Dems and Indies have left the counterpunching to the media. Who are doing a Herculean job of fact based reporting, calling out the bullying administration.
The greed factor is at play again. America is being ruled by the top 1 %. Working class folks thought Trump would "have their backs". Look at Trump now, folks.
I will not support the Dems with my cash until they bareknuckle these liars.
1
Call it what it is...
Swampcare
Swampcare
6
David the Republicans on Capitol Hill are not visionless it's just that their vision is giving more to the have mores and putting a knife in the backs of their voters. Even their marketing guy in the White House doesn't have the skills to sell this load of stinking lies.
1
Frankly, I am shocked at just how poorly the Republican Congress has been conducting itself. Almost without exception, Republican lawmakers appearing on television news bites are there to obscure and obfuscate, not clarify or explain. As I watch these people, I cannot stop thinking of just how stupid they seem to be -- inept and daft. "Who are these people and how in the world did they get elected?" I think to myself -- they resemble the popular kids who got elected to the student council in high school, but weren't that bright; they were good looking though.
They seem to think we believe them when they tell us how bad Obamacare is, as though we don't have the capacity to think for ourselves. They tell us how it is ready to collapse. Who crippled it to begin with? The GOP insisted that it was "unAmerican" to have a mandate to sign up and then forced the penalty for not signing up to be much lower than needed to properly sustain itself. These stipulations in the original bill were needed to make the thing work. So, by sabotaging it at its inception, all of us get to witness its collapse while they point the finger at Obama. And so, here we are. Good to know the GOP is really working hard for the American people, isn't it?
Clever, these GOP'ers - and despicable.
They seem to think we believe them when they tell us how bad Obamacare is, as though we don't have the capacity to think for ourselves. They tell us how it is ready to collapse. Who crippled it to begin with? The GOP insisted that it was "unAmerican" to have a mandate to sign up and then forced the penalty for not signing up to be much lower than needed to properly sustain itself. These stipulations in the original bill were needed to make the thing work. So, by sabotaging it at its inception, all of us get to witness its collapse while they point the finger at Obama. And so, here we are. Good to know the GOP is really working hard for the American people, isn't it?
Clever, these GOP'ers - and despicable.
274
The Republicans of the House Freedom Caucus are the foremost practitioners of political pornography in the United States. Demanding that the mandated benefits present in Obama Care be eliminated, makes them purveyors of obscenity. Affluent Republican white men, procuring tax cuts, that service the fossil fuel oligarchs and other wealthy donors, while exploiting women and the poorest among us, are political war criminals. The "Freedom Caucus" favors prurient policies that implicitly embrace misogyny, homophobia, and racism, and are political crimes against humanity. They need to be tried, indicted, and convicted in the docket of American Public opinion.
3
I can see David Brooks standing before Paul (Ryan, not the apostle Paul) and saying, "Almost, you persuade me to be a Democrat," not because Democrats are molded more to his liking but because Republicans have ceased to care about anything but the power to be and to remain in office. They have shown no reluctance to embrace a lecherous, vapid (David's word), egotistical, sociopath if his coattails are long enough to win them election. There is no home any longer for honest people like Brooks in the Republican party.
3
The Ridiculously Rich Republicans who wrote this bill obviously hate everyone else in America. They would make some of the most selfish monarchs of the Dark Ages blush.
This insular group of elites have no real brains. If they did they would realize as they are served lunch cooked by someone else, and use bathrooms cleaned by someone else, and their children appear at the end of the day after being raised by someone else, that their seemingly elite sphere is not as closed as they think. Germs don't care about money. They spread where they will. And pandemics will eventually hit rich as well as poor.
Healthcare that works for ALL will benefit the Ridiculously Rich Republicans as well. It will bring more practiced doctors. Develop more reliable procedures. Which will all benefit them the most! Sure, if the U.S. develops bad medical care ( like Russia) they might be able to fly to Canada or some other progressive country (like the Russian Oligarchs do). But what if there's an emergency? Does Trump's luxury Florida hotel include a well staffed hospital complete with a surgery staff???
Making sure everyone has healthcare is really the selfish thing to do! If only because it gives the elites more options.
So ... I say to those Ridiculously Rich Republicans, come join the human race! Be part of the community, at least in moneyed terms. You'll actually be safer within your high castle walls, from that smallest of all attackers ... the germ!
This insular group of elites have no real brains. If they did they would realize as they are served lunch cooked by someone else, and use bathrooms cleaned by someone else, and their children appear at the end of the day after being raised by someone else, that their seemingly elite sphere is not as closed as they think. Germs don't care about money. They spread where they will. And pandemics will eventually hit rich as well as poor.
Healthcare that works for ALL will benefit the Ridiculously Rich Republicans as well. It will bring more practiced doctors. Develop more reliable procedures. Which will all benefit them the most! Sure, if the U.S. develops bad medical care ( like Russia) they might be able to fly to Canada or some other progressive country (like the Russian Oligarchs do). But what if there's an emergency? Does Trump's luxury Florida hotel include a well staffed hospital complete with a surgery staff???
Making sure everyone has healthcare is really the selfish thing to do! If only because it gives the elites more options.
So ... I say to those Ridiculously Rich Republicans, come join the human race! Be part of the community, at least in moneyed terms. You'll actually be safer within your high castle walls, from that smallest of all attackers ... the germ!
1
Ironically, the GOP health care bill is simply sickening. It's only purpose is as a prop that can used to say "we did something we promised we'd do". And the only people it's meant for are those suckers who, beyond all reason, were conned into believing "Obamacare" was evil. And, if the bill is passed, the irony will live on as these very same people will watch their health care evaporate before their very eyes proving the old adage "a sucker is born every minute". Even the conservatives are being conned.
Will somebody please pull back the curtain on these people!!
Will somebody please pull back the curtain on these people!!
4
As someone who usually cannot concur with your columns this one hits the nail on the head. The Trumpcare bill is not well thought out, was rushed to production, and is a crazy quilt of ideas, meant only to satisfy far flung constituencies. It does not present a serious vision of what health care should be like in this country. If not Obamacare, WHAT?
2
The ultimate reason that this bill is struggling so is this: the voters ,particularly Trump supporters, don't exactly know what they want. The one statement made that rings true is: this is Republicans' one and only chance to do the right thing. So many of them are running scared. I say pass the bill. When Americans then see the mentally ill neighbor is no longer in treatment and not taking medication, when they see the huge line in the ER of their hospitals, when they see more unwanted, out of wedlock babies being born, more drug ODs and deaths, and women are dying from things that could have been treated, etc,etc, maybe they will then see the down side of the bill. But the one thing they need to recognize is, one way or another, Americans will foot the bill. It really boils down to what they want to pay for. A decent, not perfect, health care system that approaches the level of success of the rest of the free world, or a health care system that leaves many out with a great deal of collateral damage that Democrats will clean up and then be accused of hurting the country for doing so.
2
The Trump/Ryan health care plan is perhaps the most startling example yet of the vacuousness of Republican ideas on conservative governance. Trumpcare isn't an alternate to Obamacare. It's a spiteful bill based on ignorance and hate, like the man himself.
6
"But with this bill the Republican leadership sets an all-time new land speed record for forgetting where you came from." Nah, they didn't really come from there, to begin with. Suckered a bunch of low-info voters, sure. But they are not truly of them.
3
It's the same thing, not even gift wrapped to appear new!
The insurance companies wrote this, pure and simple.
The rich benefit from this, pure and simple.
The house republicans may get one more term in office, pure and simple.
The senate may bail them out and nix it, pure and simple.
The people who really need an affordable health care system won't get it.
The people who really need an workable health insurance system won't get it.
People who say we have the finest health care in the world lie.
David, I am glad you are awake to these craven "lawmakers" but being aware is no longer an antidote.
Sadly, we will go through this whole exercise again in a couple of years; meanwhile people will die, people will spiral down in sickness, people will shrug and say "what can a person do?"
SAD. BAD. MAD.
And trump voters? You asked for it; I hope you get it in spades.
The insurance companies wrote this, pure and simple.
The rich benefit from this, pure and simple.
The house republicans may get one more term in office, pure and simple.
The senate may bail them out and nix it, pure and simple.
The people who really need an affordable health care system won't get it.
The people who really need an workable health insurance system won't get it.
People who say we have the finest health care in the world lie.
David, I am glad you are awake to these craven "lawmakers" but being aware is no longer an antidote.
Sadly, we will go through this whole exercise again in a couple of years; meanwhile people will die, people will spiral down in sickness, people will shrug and say "what can a person do?"
SAD. BAD. MAD.
And trump voters? You asked for it; I hope you get it in spades.
4
First, David do you or any Republicans believe health care is a right?
If not just say so and craft your legislation with that as the intellectual base.
Ryan is a true hypocrite who wears his catholic religion on his sleeve but acts as if he never heard of the Sermon on the Mount.
That Ryan is held up as the intellect of the Republican House shows the intellectual desert that is the Republican congress.
In his heart Ryan believes that if you cannot afford health insurance you do not deserve it. That is the doctrine according to Kemp and Ayn Rand.
If not just say so and craft your legislation with that as the intellectual base.
Ryan is a true hypocrite who wears his catholic religion on his sleeve but acts as if he never heard of the Sermon on the Mount.
That Ryan is held up as the intellect of the Republican House shows the intellectual desert that is the Republican congress.
In his heart Ryan believes that if you cannot afford health insurance you do not deserve it. That is the doctrine according to Kemp and Ayn Rand.
6
Trumpcare does the following:
1) It has 14 million Americans lose their healthcare in its first year, 24 million within 10 years, and 52 million within 20 years.
2) It slashes almost a trillion dollars from Medicaid ($880 billion), a program that supports 40% of America's children, most of its disabled, and the elderly in nursing homes, among other low-income people.
3) It raids the Medicare trust fund to provide tax giveaways to the wealthy which is a time bomb to kill Medicare.
4) It erodes basic medical benefits such as maternity care, preventative care, care for mental health issues, and for additions.
5) It harms women's health through ending Planned Parenthood in an ideological purge since many low income women get their health care, cancer screenings, contraceptives and other reproductive health care at PP, while PP is a major public health force for preventing STDs through diagnosis and treatment and other public health dangers.
17% of Americans may approve Trumpcare, but I suspect that number would slip as people they love or care about start hurting and dying. By attrition if nothing else.
1) It has 14 million Americans lose their healthcare in its first year, 24 million within 10 years, and 52 million within 20 years.
2) It slashes almost a trillion dollars from Medicaid ($880 billion), a program that supports 40% of America's children, most of its disabled, and the elderly in nursing homes, among other low-income people.
3) It raids the Medicare trust fund to provide tax giveaways to the wealthy which is a time bomb to kill Medicare.
4) It erodes basic medical benefits such as maternity care, preventative care, care for mental health issues, and for additions.
5) It harms women's health through ending Planned Parenthood in an ideological purge since many low income women get their health care, cancer screenings, contraceptives and other reproductive health care at PP, while PP is a major public health force for preventing STDs through diagnosis and treatment and other public health dangers.
17% of Americans may approve Trumpcare, but I suspect that number would slip as people they love or care about start hurting and dying. By attrition if nothing else.
4
David - the GOP's overarching vision for this legislation is to cut taxes for the wealthy few, and to cut funding for programs that benefit the neediest among us, but not the wealthy few, to the bone. And if they can pervert the whole thing by adding even more tax cuts, and stripping benefits for women, children and the sick, well, that's a bonus. And the notion that anyone in today's GOP has any interest in policy that helps anyone other than the Koch brothers, the Waltons and their ilk, or themselves, or, it seems, Putin, or anything other than corporations and Russia, is quaint. It's been decades since the GOP cared about actual people or actual policy or actual vision or their actual country.
As to your market based solutions, you seem to forget, we tried those. They failed. They left one in six Americans uninsured. And the left many markets with just one insurer. And they left those in individual and small goup markets with high premiums, annual double digit percentage increases, skimpy coverage, and high deductibles and coinsurance. What on earth makes you think there will be a different result with market competition redux?
As to your market based solutions, you seem to forget, we tried those. They failed. They left one in six Americans uninsured. And the left many markets with just one insurer. And they left those in individual and small goup markets with high premiums, annual double digit percentage increases, skimpy coverage, and high deductibles and coinsurance. What on earth makes you think there will be a different result with market competition redux?
For once, David Brooks is spot on.
One more aspect. Years of self delusion and the rejection of facts have set up the Republicans to be unable to craft policy that works.
One more aspect. Years of self delusion and the rejection of facts have set up the Republicans to be unable to craft policy that works.
2
"..takes the most vicious progressive stereotyes about conservatives and validates them".
And why, exactly, would that be? Because they are not stereotypes at all but viciously accurate descriptions of conservatives.
Face it squarely and you will appear less credulous, Mr. Brooks, and perhaps more worthy of our attention.
And why, exactly, would that be? Because they are not stereotypes at all but viciously accurate descriptions of conservatives.
Face it squarely and you will appear less credulous, Mr. Brooks, and perhaps more worthy of our attention.
4
Please help me to complete this sentence: "Asking Republicans to craft a health care bill is like asking __________to____________." Many thanks.
Unto those who have more shall be given. Unto those who have not even the little they have shall be taken away. Matthew 13:12; 25:29 Mark 4:25; Luke 8:18; 19:26. These "Christians" running Congress are acting as if these teachings of Jesus are to be interpreted literally.
"Suffer and die you poor and middle class Trump voters! The extremely wealthy need tax cuts!" Ryan is worse than Marie Antoinette. I think he is evil.
Trump is foolish to go along with him. Maybe Ryan has something over Trump so Trump has to do his bidding.
"Suffer and die you poor and middle class Trump voters! The extremely wealthy need tax cuts!" Ryan is worse than Marie Antoinette. I think he is evil.
Trump is foolish to go along with him. Maybe Ryan has something over Trump so Trump has to do his bidding.
2
I guess those stereotypes aren't really vicious then are they?
1
The world watcheth. And grieveth. That America has descended to such depths, of corruption, authoritarian strong arm tactics by a leader elected in a singularly American democratic fashion where the electoral college votes pushed him into a Presidency he neither wanted nor was in the slightest bit, prepared for. Thanks Hillary!
20
Um, Mr. Brooks, sorry, but what is happening directly reflects your own and your party's long-standing argument that the free market would deliver low cost health care to everyone. But that is not true. It is simply not true. And that basic fact is finally being exposed. Health savings accounts and tax credits are never going to be effective in providing health care--that is just foolishness. You see that now that your party has free run of the legislative field. And it must be embarrassing.
527
You like health savings accounts? So do the wealthy because they benefit from them. Guess who doesn't benefit? Yup, and it's a false way of selling a "benefit" that's actually a tax.
Please stop it; stop defending the indefensible. Your twisting yourself into a pretzel to defend cruel policies that shift wealth upwards to the uber-wealthy must be so very tiring at this point.
Please stop it; stop defending the indefensible. Your twisting yourself into a pretzel to defend cruel policies that shift wealth upwards to the uber-wealthy must be so very tiring at this point.
102
The statements coming out of the Republican party about healthcare comprise an amazing exercise in obfuscation. The fundamental question is whether, in the richest society in the history of the world, every citizen should have access to adequate healthcare. If we decide that the answer is "yes", then we, as a society, have to pay for it. Unfortunately, many among us cannot afford to pay for the health care we need. In a single payer system in a society with a progressive income tax, health care for the poor is subsidized by the wealthy; this is the system I support. In Obamacare, health care for the poor is subsidized partly by the wealthy and partly by the healthy. The essential point is that the primary effect of any health care law is the redistribution of wealth; if every citizen had the resources to pay for his own healthcare, the health care law would not be necessary. The sponsers of the Republican health care bill want to greatly reduce the subsidies, and claim that health care for the poor will be paid for the "magic of the free market". This is about as likely as expecting it to be paid for by Santa Claus and the Easter bunny.
95
This is what happens when you send a bull alligator to drain a swamp.
34
Bravo! Keep this kind of talk up, straight talk and you'll be another Sinclair Lewis. At 70, which he is, there has to be some old elite being dragged in out of the muck and mire, or wherever they materialize after closing time.
4
The GOP had seven years to craft a replacement for Obamacare and this is the best they can do?!? Sad. Very SAD!!
43
We'll be winning so much we'll be tired of winning.
Are you tired of winning yet?
Are you tired of winning yet?
33
"We The People" gain absolutely nothing from this Bill, "We The People" gain absolutely nothing from this Bill.
Stand up People, Stand up and call your congressman now!
This is the greediest and most treasonous group of people ever assembled in our history, and they call themselves Republicans.
The Resistance is rising, and coming to a voting booth and street near you soon...
Stand up People, Stand up and call your congressman now!
This is the greediest and most treasonous group of people ever assembled in our history, and they call themselves Republicans.
The Resistance is rising, and coming to a voting booth and street near you soon...
42
Columnist Brooks' is well wide of the mark today in choosing the word "elites" to describe the soulless Dickensian monsters who are gutting th ACA. Nothing remotely elite going on here. Heartless. Tragic. Criminal.
45
David.
When did you wake up to see how your fellow Republican operatives actually operate?
Are you proud to see what they are doing to your fellow Americans?
Many of us find what your guys have done to us appalling.
Truly sad. Sadly, badly sad.
When did you wake up to see how your fellow Republican operatives actually operate?
Are you proud to see what they are doing to your fellow Americans?
Many of us find what your guys have done to us appalling.
Truly sad. Sadly, badly sad.
26
Mr. Brooks, don't you think is about time for you to leave the new Republcan Party wlich ia disgrace to our nation?
33
SwampCare!
29
For the 1,000th time!!!!! Trump is NOT a marketing guy - he is a salesman!!
The key to success in marketing is to stay focused on this - it's not about me.
Trump is all about Trump - he's not aware of, nor could he be bothered to care about, anyone but himself and his immediate family.
Marketing has its faults and flaws, but Trump is not one of them.
The key to success in marketing is to stay focused on this - it's not about me.
Trump is all about Trump - he's not aware of, nor could he be bothered to care about, anyone but himself and his immediate family.
Marketing has its faults and flaws, but Trump is not one of them.
22
David. Finally you have had you epiphany about the Republican Party and what it stands for.
14
And you're shocked, Mr. Brooks? Shocked?!?!? Are you just as shocked that "Republican senators moved Thursday to dismantle landmark internet privacy protections for consumers in the first decisive strike against telecommunications and technology regulations created during the Obama administration, and a harbinger of further deregulation... The move means Verizon, Comcast or AT&T can continue tracking and sharing people’s browsing and app activity without permission...?"
Wake up, sir.
Wake up, sir.
43
Trump has betrayed his country by lying.
This guy thinks he can go into his CEO mode by lying and bullying others. (Take note, Melania).
No Trump, many will take you to account, and oh, your fake news and so-called judges will be there too.
You know why? Because they a lot more qualified than you are.
This guy thinks he can go into his CEO mode by lying and bullying others. (Take note, Melania).
No Trump, many will take you to account, and oh, your fake news and so-called judges will be there too.
You know why? Because they a lot more qualified than you are.
12
Halleluah, David.
2
LOL David. At which point did you come to this realization? Just now? Come on.
Welcome to your trump land. A slow-motion crash for the next 4 years.
A party which wishes to drown government cannot govern.
Welcome to your trump land. A slow-motion crash for the next 4 years.
A party which wishes to drown government cannot govern.
43
Putin's puppet proceeds apace.
A rushin bull in a china shop.
McCain and Graham...where are you?
A rushin bull in a china shop.
McCain and Graham...where are you?
25
"It was not molded to the actual health care needs of regular voters." Tell me, Mr. Brooks, WHEN did the Republicans EVER care about the needs of "regular voters"?
55
Dear Mr Brooks,
If there were 10 men like you in Sodom. the city would have been saved.I thought I had found honorable men in the Republican Party in McCain & Graham, however,their Red underwear became obvious in interviews yesterday, especially Graham.
If there were 10 men like you in Sodom. the city would have been saved.I thought I had found honorable men in the Republican Party in McCain & Graham, however,their Red underwear became obvious in interviews yesterday, especially Graham.
16
FEDERAL SINGLE PAYER MEDICARE FOR ALL!
More sensible.
More coverage.
Less cost.
Less waste.
Less hassle.
Let's stop being stupid and join the rest of the Western world!
More sensible.
More coverage.
Less cost.
Less waste.
Less hassle.
Let's stop being stupid and join the rest of the Western world!
85
Single payer is the only solution that meets your suggested needs. Your party should fall hard giving the party that actually is willing to do the right thing for all Americans the mandate to do so . Isn't it time you quit soft peddling your version of a non existent party and join Democrats before it's too late. Perhaps with your assistance as party apologist to moderates it is already to late.
23
Mr. Brooks says he likes "health savings accounts, tax credits and competitive health care markets." I was beginning to hold out hope that Trump's election had at long last been a Road-to-Damascus moment for the NYT's designated moderate conservative. But I guess Brooks is still a Republican after all, because the only possible way to support this triad of policies is to ignore all evidence about how health care markets actually function.
31
"They could have drafted a bill that addressed the perverse fee-for-service incentives that drive up health costs, or a bill that began to phase out our silly employment-based system, or one that increased health security for the working and middle class."
David, I wish you had written a column, not just a paragraph, about that!
David, I wish you had written a column, not just a paragraph, about that!
19
There are no "vicious progressive stereotypes about conservatives". There is truth.
30
I had my third surgery for early stage breast cancer on Tuesday. As a retired NYC employee, I have good health insurance coverage. As I make choices about my treatment plan, I wonder what must this be like for women without health insurance. There are options I must consider going forward, like whether or not to do a sentinel node biopsy, which would mean a 4th surgery. I can devote my energy and concentration to the pros and cons of my care options, NOT to worrying about impending financial ruin and desperate attempts to somehow pay for my treatment, and choose a treatment plan that is cheaper rather than one that provides the best chance for long-term survival.
There was a picture widely circulated on the internet yesterday of a room full of men (House Freedom Caucus) deciding which items affecting the health of millions of women might be gutted from the GOP Obamacare replacement bill. Senator Pat Roberts (R-Kan.) mocked how he was so anxious about losing his mammogram coverage. Maternity coverage was also on the chopping block.
With years and years to work on a replacement health insurance program, a room full of men is now pressured by the president to throw something together ASAP because he has to get to Florida later today for his golf weekend. This is sheer madness, and exactly why millions of women marched in protest the day after the inauguration. Healthcare is a human right. I feel desperately anxious for women who may be considered expendable by the GOP.
There was a picture widely circulated on the internet yesterday of a room full of men (House Freedom Caucus) deciding which items affecting the health of millions of women might be gutted from the GOP Obamacare replacement bill. Senator Pat Roberts (R-Kan.) mocked how he was so anxious about losing his mammogram coverage. Maternity coverage was also on the chopping block.
With years and years to work on a replacement health insurance program, a room full of men is now pressured by the president to throw something together ASAP because he has to get to Florida later today for his golf weekend. This is sheer madness, and exactly why millions of women marched in protest the day after the inauguration. Healthcare is a human right. I feel desperately anxious for women who may be considered expendable by the GOP.
752
Seven years to craft repeal and replacement and this is the best they can come up with? It was never about health care nor will it be about medicare or social security. It is about a drive to realize an inchoate vision of a world that never was and never will be. It is about power and money and position. It is intellectually
empty and emotionally cruel.
empty and emotionally cruel.
19
Nice! The one thing I disagree with is your insistence on relying on the market. The rest of your observations are what I see, too.
4
Thank you, David Brooks.
Political competition is one way to occupy oneself - Governing is a different task.
Political competition is one way to occupy oneself - Governing is a different task.
3
There are plenty of countries that do health care well. We could learn from them, but don't. Instead, those countries get demonized for being "socialist." And Socialism is the devil making people lazy and government inefficient. But as one who does have socialized medicine called Medicare, I am amazed at how logical and efficient it is. And while no health plan will be perfect we should be pragmatic enough to fix what needs fixing for our own benefit. But first we have to accept that universal health care is better than letting fellow citizens suffer for a vapid, mean-spirited, and outdated ideology.
15
And this is only the beginning. Remember that we are only two months into this vaudeville administration. Up next, the budget, a raw demonstration of government for the plutocracy. Eventually, the scales will fall off the eyes of even the most blind of Trump and Ryan supporters as they begin to feel the pain and realize the extent of how they've been had. The convulsion of our society that might result could be truly ugly and unpredictable - I think of the street riots between the Nazis and the Communists in the dying days of the Wiemar republic, 1930s Spain, the October revolution. It might devolve into the greatest test of the American experiment since the Civil War.
4
2018 is around the corner. Where are the Democrats? How come the only critics of this so called bill are honest Republicans?
2
Millions must lose health insurance and thousands must die just so Congress can make Trump look like a great "deal maker." It's sickening watching the GOP sit around deciding how best to deprive their constituents while pledging billions for a completely useless border wall. All in the name of keeping a bunch truly vapid campaign "promises." Of course the only promises kept are huge tax cuts in the highest income brackets. The GOP is showing its true colors. Will the "base" be able to see them through the Fox smoke screen? Our fate as a nation depends on it.
16
glad that even you, Mr. Brooks, can see the TrumpCare bill for what it is: a hastily drafted bill leading to misery and early death for 24 million Americans deprived of health insurance. And to add insult to injury, all Americans will be left with health insurance that does not include "essential health benefits." No more coverage of pregnancy, no more wellness programs, no more drug coverage, no more emergency room visits. What a bonanza for the health insurance industry! How can any thinking person with ethical principles can call himself a Republican if this monstrosity becomes law?
11
The rest of the modern world recognizes that health care is not a typical market. If I'm having severe chest pains, I can't and won't "choose" not to a doctor and neither would Republicans. Health care is not a flat screen TV or a phone or a car. We have to stop validating false claims that "competition" alone can bring prices down. Demand will never go down for health care because it is a necessity. The only way to decrease demand is to make it impossible for the poor to obtain it and decrease the surplus population. Ryancare is Scrooge on steroids.
15
Another shameful exhibition of American incompetence, clownish idiocy. Imagine what the rest of the world thinks of us.
4
Meet the new boss, lamer than the old boss, eh? And this time it's Putin who can smile and grin at the change all around.
2
" ... a bill that began to phase out our silly employment-based system ... "
Can I say: "AMEN!"
I recently retired after more than 30 years of working beside people who didn't like their jobs, lacked the motivation to do them well and never, ever did anything that wasn't in their job descriptions. But they stayed and stayed and stayed, precluding better, more engaged people from employment, because without a job they would not have health insurance. Imagine the drag on organizations when health benefits are an employee's sole reason to come to work.
And that's without reckoning the expense of providing those benefits--another reason why there is so much underemployment. Most employers, knowing benefits would cost a third again what they are offering as a salary, decide to let attrition whittle their workforce down until everyone is doing multiple jobs. Exhaustion, errors and burnout are the inevitable results--creating additional drag on the organization.
Bonus: Take employers out of the healthcare business, and suddenly the owners' convictions about birth control no longer matter to anyone except the owners.
Can I say: "AMEN!"
I recently retired after more than 30 years of working beside people who didn't like their jobs, lacked the motivation to do them well and never, ever did anything that wasn't in their job descriptions. But they stayed and stayed and stayed, precluding better, more engaged people from employment, because without a job they would not have health insurance. Imagine the drag on organizations when health benefits are an employee's sole reason to come to work.
And that's without reckoning the expense of providing those benefits--another reason why there is so much underemployment. Most employers, knowing benefits would cost a third again what they are offering as a salary, decide to let attrition whittle their workforce down until everyone is doing multiple jobs. Exhaustion, errors and burnout are the inevitable results--creating additional drag on the organization.
Bonus: Take employers out of the healthcare business, and suddenly the owners' convictions about birth control no longer matter to anyone except the owners.
9
I am sorry David but I think your "new elite" is just the "old elite" unmasked, because it has become popular in the party, aka Trump like, to be "authentic" in your prejudices, greed, and selfishness. You know, like Trump said, "of course, I'd use the whatever to pay less taxes or no taxes, that just makes me smart" and we want to make America Great Again, by keeping immigrants out! David, what is obvious to most of us, is the Republicans are NOT who you thought they were. IF they were, who you thought, they would have had a "bottom up" healthcare bill in place long ago. They would have done their own cost analysis before Trump ever was President and realized what it would take to offer health care savings, tax credits, etc. etc. and that the costs was just TOO high in human suffering and struggle! They would have had the moral decency and integrity to tell Trump, our so-called president, that this is NOT who we are in America, or in the world, or under heaven, as we are called to treat others as you want to be treated. Inverted this statement could be, "Don't treat others how you would hate to be treated". Your "new elite" Republicans have done both! As the Bible says, "out of the overflow of your heart, your mouth speaks" and what is spewing forth from them is pure greed and selfishness, with no thought to "the least of these their brothers". "America, America, God shed His grace on thee and crown Thy good with brotherhood, from sea to shining sea".
10
I wouldn't like Mr. Brooks "enlightened" Conservative version of health care either. Single payer--like the rest of the world where health care is readily accessible and measures of health out pace the US--is the only way to go.
9
Yes, let's Make America Vapid Again! Wouldn't it be hilarious if DT had to answer questions from the press about what the Ryan bill actually includes or doesn't? He wouldn't have a clue. The fissures in the GOP are magnified by the vapid cheeto.
9
Congress should pay attention to the outcry and throw this travesty of a bill in the trash, and David, you might want to consider changing your political party. The Republicans are an utterly selfish failure as is their delusional leader.
10
Healthcare is a right. Its practice a privilege. Neither is elitist. This bill is.
We take away from the least fortunate and able to pay and we are all demeaned by the result. There are no easy or inexpensive options. All must accept sacrifice for the betterment of our nation, our diverse society with so many physical/medical needs. But a healthier nation is a more vibrant and productive society, both in mind and in spirit.
Thank you, as always, David for your keen (and yes conservative) observation of the real goings on in the machinations of government gone awry.
We take away from the least fortunate and able to pay and we are all demeaned by the result. There are no easy or inexpensive options. All must accept sacrifice for the betterment of our nation, our diverse society with so many physical/medical needs. But a healthier nation is a more vibrant and productive society, both in mind and in spirit.
Thank you, as always, David for your keen (and yes conservative) observation of the real goings on in the machinations of government gone awry.
5
The reference to fee for service is an old idea and false. It is associated with Medicare. Advantage and other group type services like the majority of HMO deliver substandard services and spend a lot on transportation and non medical for beneficiaries.
The idea that the sick or the old or people with chronic diseases pay more is arrogant. I gladly paid all my life for additional insurance through my employer and hardly used it and thanked God for not being in the shoes of others.
There is also abuse but mostly arrogance on the part of those who make rules and preeminent columnists of all political stripes that pontificate based on statistics but never have gone in the field or incognito to see what Ishappening first hand
The combination of pardon my French of Democrats to foster more small businesses transferred the burden of costs to smaller companies
It is not easy but there is abuse and by God illness is difficult and people who are in government already wealthy who will not encounter illness they could not afford healing or a good death should shut up. That said doctors medical related services hmos people with private hospices people abusing medicaid all that abuse the law should be criminally prosecuted. Which of the prominent people in 80s and higher will due an awful death in some forsaken hospice?
The idea that the sick or the old or people with chronic diseases pay more is arrogant. I gladly paid all my life for additional insurance through my employer and hardly used it and thanked God for not being in the shoes of others.
There is also abuse but mostly arrogance on the part of those who make rules and preeminent columnists of all political stripes that pontificate based on statistics but never have gone in the field or incognito to see what Ishappening first hand
The combination of pardon my French of Democrats to foster more small businesses transferred the burden of costs to smaller companies
It is not easy but there is abuse and by God illness is difficult and people who are in government already wealthy who will not encounter illness they could not afford healing or a good death should shut up. That said doctors medical related services hmos people with private hospices people abusing medicaid all that abuse the law should be criminally prosecuted. Which of the prominent people in 80s and higher will due an awful death in some forsaken hospice?
1
I do not understand why you would have opposed the ACA if it was the Republican Health Care bill from 1992 (minus Tort Reform, plus Medicaid expansion [which was partially trailed by the SCOTUS]). Liberals wanted the system that every other industrialized democracy has created to provide health care for their populations in a cost-effective way: single payer. We did not even get a public option.
Maybe that will now emerge out of the ashes of the GOP dumpster fire.
Maybe that will now emerge out of the ashes of the GOP dumpster fire.
6
I'm an Australian. Our current radically conservative government is trying to destroy our "universal" health care system. That particular party has been trying to do this since 1975, and we aren't letting them. We will eventually vote in a government that supports universal health care. Why don't you just bite the bullet and implement a universal free healthcare system for everyone, based on a tax levy? It works, and it's popular with the voters, and they don't mind paying the tax.
I bet everyday American taxpayers would like it, given the chance, and they would vote for a government which could do that. Even if it was Trump's party.
Further, you would find that your health care would be of much better quality and it would be much cheaper. It takes out all the fat-cat middlemen. They would be the insurance company executives, whose exotic lifestyles you currently subsidise at the expense of your ability to get treatment for your illnesses.
I bet everyday American taxpayers would like it, given the chance, and they would vote for a government which could do that. Even if it was Trump's party.
Further, you would find that your health care would be of much better quality and it would be much cheaper. It takes out all the fat-cat middlemen. They would be the insurance company executives, whose exotic lifestyles you currently subsidise at the expense of your ability to get treatment for your illnesses.
17
"This bill takes the most vicious progressive stereotypes about conservatives and validates them."
Only Republicans and "Conservatives" themselves considered their reputed hatred of the poor and economically disadvantaged, their greed & their self-serving ways to be shallow stereotypes.
Democrats and Independents and those not allowing themselves to become delusional by Right Wing media knew all along that those were not shallow stereotypes but rather, spot-on absolute truths.
The modern Republican/Conservative party has become a humanity-despising, deceptive, self-righteous elitist monster.
Only Republicans and "Conservatives" themselves considered their reputed hatred of the poor and economically disadvantaged, their greed & their self-serving ways to be shallow stereotypes.
Democrats and Independents and those not allowing themselves to become delusional by Right Wing media knew all along that those were not shallow stereotypes but rather, spot-on absolute truths.
The modern Republican/Conservative party has become a humanity-despising, deceptive, self-righteous elitist monster.
10
Tax cuts for the very wealthy and health care cuts for the rest of us. What a great deal.
Forget repeal. Moderate Republicans should work with Democrats to make necessary reforms to the ACA which has already vastly reduced the number of Americans without health insurance.
Forget repeal. Moderate Republicans should work with Democrats to make necessary reforms to the ACA which has already vastly reduced the number of Americans without health insurance.
11
Absolutely! The " health care" vote is now all about winning or losing, a politician saving face. It is totally ignoring truly supporting health care for individuals who have no insurance coverage connected with their work or education or any group. Totally politician power driven and not considering citizen and family needs or social structure preservation.
3
David great article. You are sounding more like a moderate Democrat than a conservative Republican. It's ok, we embrace all those who oppose the "man behind the curtain" and those in the GOP who seek to diminish us by their actions. Trumpcare is a farce to make Trump look like he's won again. He is a little man pushing little men to achieve his ends.
What everyone, especially Republicans need, is a face saver. What if the new health plan were called TRO (TrumpRyanObama) care. Start with the ACA and let Republicans suggest tweaks to it, with a few "givens," such as there will be no tax breaks for the wealthy, the individual mandate remains in effect, and the amount spent on the ACA will continue at the same level. No increase, no decrease. In effect, the goal would be to level the pain...those that have had a hard time under the ACA will get relief, paid for by increasing the burden on the wealthy. Problems solved!
Mr. Brooks says he likes health savings tax credits, etc. What I like is workers getting paid a living wage so they do not need big government economic engineering gimmicks like tax credits.
And as for "Republicans can't run policy-making form the White House...", the GOP has had Congress 6 of 8 years each under Obama, Bush, and Clinton. I say they cannot run policy at all. I point to Kansas.
And as for "Republicans can't run policy-making form the White House...", the GOP has had Congress 6 of 8 years each under Obama, Bush, and Clinton. I say they cannot run policy at all. I point to Kansas.
2
Republicans cannot provide the citizens of the US with a well thought out comprehensive health care bill, and they never have. The reasons are multiple, but at base are some facts that they seem unable to accommodate. Among these are:
1) In virtually all wealthy democratic nations, and some others as well, universal health care is a given, and a very popular one.
2) Every universal health care program involves a significant role by government.
3) Republicans do not, and never have, favor or support universal health care -- too socialistic.
4) Instead, they argue as a matter of faith for a "market" driven system, no example of which exists anywhere on the planet.
5) This market-based system is based on the undocumented notion that competition will take care of most problems, including cost, a premise for which there is much contrary evidence (e.g. in the US, who thinks that seniors on Medicare would be better off in a "free market"?).
6) Government is not inherently a bad thing. It's a necessary thing. And it's a necessary element of any comprehensive health care plan.
Finally, as a result of these accumulated facts, and to the best of my knowledge, no Republican -- not Ryan, not Price -- has as yet put forth a fully vetted and scored plan of any sort.
1) In virtually all wealthy democratic nations, and some others as well, universal health care is a given, and a very popular one.
2) Every universal health care program involves a significant role by government.
3) Republicans do not, and never have, favor or support universal health care -- too socialistic.
4) Instead, they argue as a matter of faith for a "market" driven system, no example of which exists anywhere on the planet.
5) This market-based system is based on the undocumented notion that competition will take care of most problems, including cost, a premise for which there is much contrary evidence (e.g. in the US, who thinks that seniors on Medicare would be better off in a "free market"?).
6) Government is not inherently a bad thing. It's a necessary thing. And it's a necessary element of any comprehensive health care plan.
Finally, as a result of these accumulated facts, and to the best of my knowledge, no Republican -- not Ryan, not Price -- has as yet put forth a fully vetted and scored plan of any sort.
9
The difficulty in the U.S. of creating a cutting edge concept of health itself and a health care system which is second to none, just as we have a military which is "second to none, the most advanced in the world"?
Health is an interesting concept, and as it turns out, perhaps the most ubiquitous yet subtle and dangerous concept today, one which if examined in all its ramifications is an automatic questioning and probable indictment of power in even the most advanced societies. Imagine every citizen really asking: What is being done to compromise optimal functioning of my mind and body in society today? What is this food I am eating? What is this environment in which I work? What is this work that I do? What is this mental environment in which I am forced to live? Not to mention all the intricacies of actual administration of such a system.
Yet in the U.S. how often have citizens had anything like a coherent examination of the problem? How often have there been before the public close comparisons in every respect between the U.S. and other nations whether Singapore or Finland or Austria? I have never seen a coherent discussion of health in the U.S. What I have seen is a mind frustrating discussion of pure legal/administrative/economic minutia (if even that) which might as well be a foreign language to most Americans.
I have come to the conclusion that America, land of the free, home of the brave, does not have the courage to even ask what it means to be healthy.
Health is an interesting concept, and as it turns out, perhaps the most ubiquitous yet subtle and dangerous concept today, one which if examined in all its ramifications is an automatic questioning and probable indictment of power in even the most advanced societies. Imagine every citizen really asking: What is being done to compromise optimal functioning of my mind and body in society today? What is this food I am eating? What is this environment in which I work? What is this work that I do? What is this mental environment in which I am forced to live? Not to mention all the intricacies of actual administration of such a system.
Yet in the U.S. how often have citizens had anything like a coherent examination of the problem? How often have there been before the public close comparisons in every respect between the U.S. and other nations whether Singapore or Finland or Austria? I have never seen a coherent discussion of health in the U.S. What I have seen is a mind frustrating discussion of pure legal/administrative/economic minutia (if even that) which might as well be a foreign language to most Americans.
I have come to the conclusion that America, land of the free, home of the brave, does not have the courage to even ask what it means to be healthy.
David - you have it right. This bill is all about politics and nothing about the healthcare needs of people. Shame on Trump and the House GOP.
1
It is called murder a government acts knowing someone will die.
This health bill proposed by Mr Ryan is at best manslaughter. People will suffer. or die. In Massachusetts the population is said to be insulated thanks to policies put in place to some extent by Governor Romney and our congressional delegation and of course Obama.
Most Americans know this bill will put them at risk. if the anger at town halls is any indication. The 2018 elections will be the Republicans' reward.
This health bill proposed by Mr Ryan is at best manslaughter. People will suffer. or die. In Massachusetts the population is said to be insulated thanks to policies put in place to some extent by Governor Romney and our congressional delegation and of course Obama.
Most Americans know this bill will put them at risk. if the anger at town halls is any indication. The 2018 elections will be the Republicans' reward.
2
So Americans should be headed to Washington and protesting loud and clear against this abomination.
6
In a very simple way the GOP health care mantra is Get Healthy, Get Wealthy, or Die
1
Top Down = Oligarchy
Another important element, besides the three Mr. Brooks mentions, that allowed this bill to become "pure swamp" are the safe congressional districts that elect these swamp denizens. Many congressional districts have been so gerrymandered by state legislatures that the people writing these poor excuses for laws need fear only their lobbyist paymasters and watchful people to their right. Congressmen, such as Iowa's King and Georgia's Carter for example, are free to vote, act, and speak in nonsensical ways as long as they don't upset those to their right on abortion, taxes, the Second Amendment, immigration,and hatred for all things Obama. When member of a party have acted so irresponsibly for eight years--without consequences at the ballot box-- it is no wonder they fail to govern when called on to do so.
"It’s no wonder that according to the latest Quinnipiac poll this bill has just a 17 percent approval rating."
But what does that 17% mean when most Americans have no idea what is IN the bill? Perhaps only 17% of Americans think that Pluto is a planet. Perhaps only 17% believe that there is no such thing as dark matter.
But what does that 17% mean?
Not a hill of beans.
But what does that 17% mean when most Americans have no idea what is IN the bill? Perhaps only 17% of Americans think that Pluto is a planet. Perhaps only 17% believe that there is no such thing as dark matter.
But what does that 17% mean?
Not a hill of beans.
There never can be a "free market" in health care. Sure the sellers are free to leave the market, but few of the buyers are free to leave the market.
Let's hope it doesn't happen to you, but suppose you are in a car crash on a rural road. First responders find you unconscious and decide to send you to a big city hospital rather than the nearest small town hospital. Depending on the severity of your injuries, they call an ambulance (very expensive) or a helicopter (really expensive). Oh yes, there is no free market in either because there are not many sellers of either, not many being only one.
There can be a free market in insurance providers, but how free is a market when there are only five or six providers in your market?
Let's hope it doesn't happen to you, but suppose you are in a car crash on a rural road. First responders find you unconscious and decide to send you to a big city hospital rather than the nearest small town hospital. Depending on the severity of your injuries, they call an ambulance (very expensive) or a helicopter (really expensive). Oh yes, there is no free market in either because there are not many sellers of either, not many being only one.
There can be a free market in insurance providers, but how free is a market when there are only five or six providers in your market?
1
And all this from the party that demolished the Clinton attempt at healthcare by vowing to devise their own plan. And next to 'replace' the ACA with their own plan. As I look at the calendar that's twenty-five years to come-up with a plan. And this is the best they can do? Well done.
2
Well said, David. If we were watching this government operate in some far away place, we'd see if for what it is: barbaric. The notion that a federal "health care" law would purposefully eliminate coverage for emergency services, maternity care and mental health (among others) is beyond the pale. I don't know when we bought this ticket to ruin, but the stops we took in Sandy Hook and the Pulse nightclub shooting (government turning a blind eye after the slaughter of young children in their classrooms and the deadliest mass shooting), in whatever is going on with the Russian government and our elections, and in the bone-chilling callousness of this "health care" bill do not bode well for the future of this country.
1
Mr. Brooks, you got this one right. May not agree with your prescriptions and solutions for healthcare; but the chaos coming from the White House, and the sheer arrogance of house republicans to plan a vote on a health care package that will most likely place our health care at the bottom in the industrialized world, and further the our economic divide. What is the end game? How does this move us toward a healthy populace and a stable domestic economic system working to benefit all citizens
Let's talk about health savings accounts in the context of other tax write offs proposed by politicians in the past to assuage some of the ills of living, aging and dying.
Take the mortgage deduction. Studies prove this doesn't raise the poor out of poverty because they don't have enough seed cash to buy in. But those of means can use it even to buy a second home.
Take the IRA deduction. It's fine if you have something to put into the IRA to start with, but when you don't earn enough to have discretionary income, you don't have the seed money to fund your eventual retirement.
The same is true of the ROTH IRA, which is a giveaway to those who already have. And 401-Ks have become honey hives for the handlers who skim fees in the billions from any poor sucker's meager wealth.
Health savings accounts? Americans are so financially illiterate that many didn't understand that Obamacare was the ACA. They were flummoxed by the design of plans, by the notion of co-pays and deductibles. The ACA was designed with at least enough nanny oversight that the insurance companies had to sell plans with some value and substance.
Tax credits? Huh? Health savings accounts? Huh? This is bait and switch. Worthless when you're poor. This bill is a license to sell empty plans with a lot of fine print, which will translate as: We hope you are dying of something catastrophic because we want to cash you out quickly to keep our profits high.
Take the mortgage deduction. Studies prove this doesn't raise the poor out of poverty because they don't have enough seed cash to buy in. But those of means can use it even to buy a second home.
Take the IRA deduction. It's fine if you have something to put into the IRA to start with, but when you don't earn enough to have discretionary income, you don't have the seed money to fund your eventual retirement.
The same is true of the ROTH IRA, which is a giveaway to those who already have. And 401-Ks have become honey hives for the handlers who skim fees in the billions from any poor sucker's meager wealth.
Health savings accounts? Americans are so financially illiterate that many didn't understand that Obamacare was the ACA. They were flummoxed by the design of plans, by the notion of co-pays and deductibles. The ACA was designed with at least enough nanny oversight that the insurance companies had to sell plans with some value and substance.
Tax credits? Huh? Health savings accounts? Huh? This is bait and switch. Worthless when you're poor. This bill is a license to sell empty plans with a lot of fine print, which will translate as: We hope you are dying of something catastrophic because we want to cash you out quickly to keep our profits high.
3
Mr. Brooks is correct in his condemnation of the proposed health care bill - but he follows the House Republicans even deeper into the same swamp with his insistence that the real solution is the "free market" that will drive down costs. That is because there is no free market for health care. A free market only exists where there are willing sellers and willing buyers. When you have cancer, a heart attack, a stroke or a major traumatic injury you are not a willing buyer, you are a compelled buyer. The same is true of those living in Florida who want to buy plywood when the forecast is for a Category 5 hurricane the next day. A number of states recognize this problem by prohibiting stores such as Home Depot from raising prices in the face of environmental disasters. It is time we face reality: The claim that the free market will magically drive down the costs of health care is nonsense because there is no free market for healthcare. That is why the most cost effective system for healthcare is and always will be Medicare or something similar.
3
The party of fiscal responsibility? I guess that went out the window with human decency as well.
The GOP had SEVEN YEARS to come up with an alternative to the ACA, but they act like that guy in college who never did the work until the last week of classes - pounds a few Red Bulls, pulls an allnighter, and freaks when he gets his failing grade.
If this bill fail, which I certainly hope it does, then you can count on Trump blaming Ryan and the rest of congress. If it passes, expect Trump to take full credit for this odious bill.
Let the finger pointing begin.
The GOP had SEVEN YEARS to come up with an alternative to the ACA, but they act like that guy in college who never did the work until the last week of classes - pounds a few Red Bulls, pulls an allnighter, and freaks when he gets his failing grade.
If this bill fail, which I certainly hope it does, then you can count on Trump blaming Ryan and the rest of congress. If it passes, expect Trump to take full credit for this odious bill.
Let the finger pointing begin.
2
Trumps WealthCare Bill will only bring Single Payer Healthcare sooner.
People are not as dumb as Washington thinks it is. We Elected a Democrat president with a filibuster proof Congress and we got a Republican Healthcare bill ( Romneycare).Lets not kid ourselves , its pretty horrible.
This time we need real progressives in office to get single payer. It is the only system that controls costs.
No more Corporate Dems. They are owned by the same people that bribe the Republicans to do their bidding.
People are not as dumb as Washington thinks it is. We Elected a Democrat president with a filibuster proof Congress and we got a Republican Healthcare bill ( Romneycare).Lets not kid ourselves , its pretty horrible.
This time we need real progressives in office to get single payer. It is the only system that controls costs.
No more Corporate Dems. They are owned by the same people that bribe the Republicans to do their bidding.
This bill has so little substance and so much hype to it. I am afraid that this is what we can expect from the Trump White House and the GOP for the foreseeable future, for the reasons Mr. Brooks spells out clearly in his final paragraph.
Smart people have repeated time and again that effective government is not run the same way as an effective business. So an effective business leader will not automatically succeed as an effective government leader. There are overlaps, to be sure - controlling expenses should be one of them; weeding out operational conflicts and streamlining processes should be another. But the strategic thinking of business is vastly different from government, the goals are different, the funding mechanisms are different, and on and on.
Furthermore, anyone who has followed Mr. Trump's career in any manner apart from his own prognostications knows that he is a consummate marketer, but less than a stellar administrator or manager. I am not convinced that he has even been a particularly good business leader, which is different from the other two roles. And don't even get me started on ethics and values.
The GOP has had from 1993 (or before!) to the present to come up with a conservative answer to providing health care in this country. It is clear that they really do not want to provide health care. Their constituents simply want to make a ton of money providing it. This bill demonstrates that the GOP could really not care less.
Smart people have repeated time and again that effective government is not run the same way as an effective business. So an effective business leader will not automatically succeed as an effective government leader. There are overlaps, to be sure - controlling expenses should be one of them; weeding out operational conflicts and streamlining processes should be another. But the strategic thinking of business is vastly different from government, the goals are different, the funding mechanisms are different, and on and on.
Furthermore, anyone who has followed Mr. Trump's career in any manner apart from his own prognostications knows that he is a consummate marketer, but less than a stellar administrator or manager. I am not convinced that he has even been a particularly good business leader, which is different from the other two roles. And don't even get me started on ethics and values.
The GOP has had from 1993 (or before!) to the present to come up with a conservative answer to providing health care in this country. It is clear that they really do not want to provide health care. Their constituents simply want to make a ton of money providing it. This bill demonstrates that the GOP could really not care less.
1
They will pass a great bill today if:
1. You are wealthy.
2. If you are poor or middle class and never need health care.
All others need no apply.
Otherwise this bill is a tax cutting measure for the rich.
Shame on he who promised a cheaper and better ACA. He lied again.
1. You are wealthy.
2. If you are poor or middle class and never need health care.
All others need no apply.
Otherwise this bill is a tax cutting measure for the rich.
Shame on he who promised a cheaper and better ACA. He lied again.
Rural states like WV can't attract doctors or competitive insurance- and no one wants to add a bunch of older, obese, drug and alcohol addicted people to their risk pool. Block granting Medicaid and cutting Medicare will sink this precarious ship, while ACA has helped folks who still voted for Trump in droves. Congress won't even back up health insurance for retired miners and their survivors, due to expire in April (along with quite a few miners). The market wants to reward people who engage in healthful behavior, like exercise and diet and no smoking. Our market leads the country in tobacco use, obesity and pedestrian car deaths on narrow rural roads. We benefited from taxing tanning beds and tobacco (making unhealthful behavior expensive) more than we ever would from market forces you believe in. I thought you were going to try and get out of D.C. to better understand Trump voters. They are not going to benefit from this law for sure, but they claim to believe in the market forces fairy like you do.
David you and republicans always state in your change in healthcare "let competition drive the cost down". Please do your homework healthcare does not have competition. Doctor's, hospitals, and yes insurance companies are if not monopoly, they are oligopoly. Proof, try and ask the price of a surgery prior to surgery. They can't tell you, just send the bill after something you need to live. How can you shop and compare. If you can't it is a monopoly. The only question then is how you deal with the monopoly, regulate it, break it up, or government take over. No one democrats or republicans know how to break it up, so heavy regulations or government take over.
david: you opposed obama care: some combo of tax cuts, health savings accounts and a competitive private market. what about the people that don't have the income for tax credits or contributions to an hsa. who do you think the sickest are? they don't have the money!! your idea of tax credits and hsa is exactly the same as "let them eat cake" the people are rioting not because there's a lack of grain, but because they don't have the money!!, to buy bread much less cake. the people don't have the money!!,and they pass they're inability to get care, and inflate it's cost to us via emergency rooms. i want to think someone the nyt would hire as a columnist is reasonably intelligent and informed but did you ever take basic micro economics or behavioral economics? for a national size group healthplan to work well, it needs to cover a lot of people, well and sick, a lot of existing health conditions, both pre existing and yet to occur, it has to get ahead of and decrease future health costs via preventative care and advice, and there have to be incentives to join and disincentives not to. sounds like obamacare and anything else is not going to work as well. any well designed plan is going to have many of the same components because all these plans are subject to the same forces and realities. all cars look the same now because they are subject to the same high fuel efficiency requirements and the physics of aerodynamic efficiency are a given, unchangeable reality.
1
Trump doesn't care about policy or legislation except for the fact that he can claim to "win" when something gets passed? There's a shocker.
The GOP theology for many years, on virtually every issue, has been three tenets:
1. Everything that Obama did for eight years was bad and needs to be junked.
2. The world is better for middle and lower income if they have "free choice for the individual" in the "marketplace," no matter what the market, no matter what the issue.
3. Give the better off more money and cut regulation, and through the magic of the free market they will create jobs!
The GOP has been marketing this pablum as a combination of Adam Smith and Ayn Rand all rolled into one. The GOP now spends its time fighting among itself about which of the three tenets is more important.
But when you don't have the money to buy health insurance, free choice equals no choice. When banks get it both ways--they can keep the profits they earn but know that the taxpayers will bail them out if they take too much risk and fail--that is not a free market. Repealing regulations will not spur investment if underlying demand--which comes mostly from middle class consumers--is not there. And simply cutting taxes to corporations and the better off has never been shown to spur investment, create jobs or "trickle down" to anyone (see, e.g., Reagan's tax cuts).
Mr. Brooks could write this same column about virtually every current GOP proposal on most issues.
The GOP theology for many years, on virtually every issue, has been three tenets:
1. Everything that Obama did for eight years was bad and needs to be junked.
2. The world is better for middle and lower income if they have "free choice for the individual" in the "marketplace," no matter what the market, no matter what the issue.
3. Give the better off more money and cut regulation, and through the magic of the free market they will create jobs!
The GOP has been marketing this pablum as a combination of Adam Smith and Ayn Rand all rolled into one. The GOP now spends its time fighting among itself about which of the three tenets is more important.
But when you don't have the money to buy health insurance, free choice equals no choice. When banks get it both ways--they can keep the profits they earn but know that the taxpayers will bail them out if they take too much risk and fail--that is not a free market. Repealing regulations will not spur investment if underlying demand--which comes mostly from middle class consumers--is not there. And simply cutting taxes to corporations and the better off has never been shown to spur investment, create jobs or "trickle down" to anyone (see, e.g., Reagan's tax cuts).
Mr. Brooks could write this same column about virtually every current GOP proposal on most issues.
1
I thought this was clear, concise and hit the nail on the head. I am a fairly liberal democrat and it's true--my mind is starting to go toward some scary theories about the agenda of some Republican politicians (and the big money behind them). I wonder... could it be possible that they actually want the poor, the sick, and the disabled to just die or leave the country? It seems to me that they are actually trying to thwart the creation of conditions where anyone who isn't white, male, and wealthy is able to thrive. I don't like to consider such sinister motives, but is almost the only way I can make sense of such an inhumane bill. I doesn't make any sense. This doesn't represent American values. Even more, this isn't even what people want. The right-wing media has been laying the groundwork for this, stirring up fear and a ferocious hatred of anything Obama for a long time. The Trump voters have been successfully manipulated and confused, and now Steve Bannon and his apparent colleagues in our government are ready to create a their own, insular, scary country. Yikes. I'm wondering if it is time to get out! But, hey. That's exactly what those hard-line conservatives want. Ugh!
1
Why not drop all pretense and leave the Freedom (to get sick and die) Caucus behind and craft a bill with House GOP moderates, if there is still such an animal, and willing Democrats? Who knows, a new, more collaborative congress might be in the offing. How can we take seriously a health care bill that essentially has had any semblance of health care services scrubbed clean out of it by the right wingers who apparently are being allowed to run the show? Paul Ryan this week demonstrated that he hasn't a clue how insurance even works but President Trump is with him all the way because as the days tally up we've come to realize POTUS doesn't know how anything works. Imagine four years of this. Better yet, don't. Anxiety disorders and depression will no longer be covered by your health insurance.
If tax credits, health care accounts and competitive markets are the basis of your health care system, David, you are doomed to come up with some hodgepodge like the Republicans came up with. The basis of a health care system should be HEALTH CARE! Fashion the system to take care of the most people at the most reasonable cost.
You are right that the bill the Republicans came up with was simply to have something to say Obamacare is repealed. What is obvious is that the Republican Emperor never did have any clothes. How many years have they been voting to repeal Obamacare and saying they would have something better to replace it with? Those of us who were paying attention knew it was a grand lie. Now even the Fox News worshippers ought to see it was a grand lie - except they probably won't, because Fox News will tell them it was a wonderful exercise in legislation.
And finally, David, when are you going to take on Fox News and denounce it for what it is - propaganda for the far right, and nothing more?
You are right that the bill the Republicans came up with was simply to have something to say Obamacare is repealed. What is obvious is that the Republican Emperor never did have any clothes. How many years have they been voting to repeal Obamacare and saying they would have something better to replace it with? Those of us who were paying attention knew it was a grand lie. Now even the Fox News worshippers ought to see it was a grand lie - except they probably won't, because Fox News will tell them it was a wonderful exercise in legislation.
And finally, David, when are you going to take on Fox News and denounce it for what it is - propaganda for the far right, and nothing more?
I just wish Ryan and his ilk would be honest and say, "If you can't afford health care, we don't think you deserve it."
They don't believe affordable care is a basic right. If the poor and middle class suffer, so be it in their eyes. Clearly they didn't work hard enough and they deserve what they get, up to and including death.
They don't believe affordable care is a basic right. If the poor and middle class suffer, so be it in their eyes. Clearly they didn't work hard enough and they deserve what they get, up to and including death.
Sorry Mr Brooks, but you got the core republican problem wrong in your concluding paragraph.
The core republican problem is that the republicans are party hacks first, last and foremost. They are incapable of governance and their only interest is self aggrandizement at the expense of those American people who don't agree with their social policing. All the Trump coterie have added to the recipe is the seasoning of Russian money and meddling in our election.
The republicans have eaten their dogfood propaganda for so long, they've morphed into the lapdogs currently best personified by Devin Nunes. He won't be the last. Oh for the days when proud republicans like Tom Delay, Dennis Hastert, Mark Foley, Dick Cheney, and so many others showed the country how Congress could best benefit their own interests. ... oh, wait ...
The core republican problem is that the republicans are party hacks first, last and foremost. They are incapable of governance and their only interest is self aggrandizement at the expense of those American people who don't agree with their social policing. All the Trump coterie have added to the recipe is the seasoning of Russian money and meddling in our election.
The republicans have eaten their dogfood propaganda for so long, they've morphed into the lapdogs currently best personified by Devin Nunes. He won't be the last. Oh for the days when proud republicans like Tom Delay, Dennis Hastert, Mark Foley, Dick Cheney, and so many others showed the country how Congress could best benefit their own interests. ... oh, wait ...
"This bill takes the most vicious progressive stereotypes about conservatives and validates them."
For once you are right, Brooks. Given enough power, the Republicans are showing their real colors. Now if the mainstream media would only show how Gorsuch has never been an impartial judge of anything, but rather an ultra-right reactionary hiding behind various lies and diversions as far back as his college days. To paraphrase what GB Shaw once said - behind the mask of the Christian is Caesar.
For once you are right, Brooks. Given enough power, the Republicans are showing their real colors. Now if the mainstream media would only show how Gorsuch has never been an impartial judge of anything, but rather an ultra-right reactionary hiding behind various lies and diversions as far back as his college days. To paraphrase what GB Shaw once said - behind the mask of the Christian is Caesar.
1
I am satisfied that you make a very strong argument for reason and professional legislative activity. I even agree with many of your points here - all focusing on the unacceptability of this Act. However, you presume too much when stating that the GOP listens to the People, and this time has turned a deaf ear.
The GOP have never been conservatives as you wish to paint them. They are anarchists and radicals. They are in fact a Confederate Army that has always and will always focus their energies on the destruction and dissolution of our Union. They do not want to listen to the People.
The GOP have never been conservatives as you wish to paint them. They are anarchists and radicals. They are in fact a Confederate Army that has always and will always focus their energies on the destruction and dissolution of our Union. They do not want to listen to the People.
1
"I like health savings accounts...."
...which only work for the rich...
"tax credits"
...which only work for the rich....
"...and competitive health care markets to drive down costs..."
which do not and have never existed on the face of the planet, because healthcare is not like rice, you can't substitute potatoes for it. Local hospitals are oligopolies; once you're in the hospital you're at the mercy of a monopoly: you can't say, "No, I'll get this test down the road because it's cheaper there."
Drug prices are regulated everywhere in the world but here, where Medicare is barred by law from negotiating prices, even though much of modern medicine is based on research done at the government's expense.
When you're sick you can't put your healthcare up to the lowest bidder - because you're sick, and because you don't have the knowledge to make knowledgeable decisions. Everybody in the world seems to know this - but Republicans, beholden to "competition" in a market that is noncompetitive by nature.
Perhaps you'd like competing armies to drive down the cost of military spending, as well?
...which only work for the rich...
"tax credits"
...which only work for the rich....
"...and competitive health care markets to drive down costs..."
which do not and have never existed on the face of the planet, because healthcare is not like rice, you can't substitute potatoes for it. Local hospitals are oligopolies; once you're in the hospital you're at the mercy of a monopoly: you can't say, "No, I'll get this test down the road because it's cheaper there."
Drug prices are regulated everywhere in the world but here, where Medicare is barred by law from negotiating prices, even though much of modern medicine is based on research done at the government's expense.
When you're sick you can't put your healthcare up to the lowest bidder - because you're sick, and because you don't have the knowledge to make knowledgeable decisions. Everybody in the world seems to know this - but Republicans, beholden to "competition" in a market that is noncompetitive by nature.
Perhaps you'd like competing armies to drive down the cost of military spending, as well?
5
An actual David Brooks column where I almost thought I could agree with 100%. Brooks gets the Republican disaster and outright viciousness and incompetence exactly right. But then he has to prove his conservative credentials that he opposed Obamacare too. He believes in the magical unicorn known as free-market healthcare - there's no such thing: once you have a guaranteed outcome, that we don't people to die from a lack medical care and healthcare and that benefit should be accorded to 100% of the people - the you end up with a government run healthcare insuance - like Medicare for all, like what every other industrialized country rich enough to provide it does for all its citizens. The inability to understand this fundamental concept is why conservatives cannot ever get healthcare fundamentally right. Of course, free market forces can be used in the delivery of medical care, but the insurance needs to be single payer, government run like every other country with intelligent, competent leaders and not with the free market will solve all problems ideologues making a mess. We have the Ryan con job with Freedom caucus free market idiotic zealots with Trump's uber con job. So instead of making some necessary adjustments to ACA/Obamacare (a public option for the exchanges), we get the unmitigated disaster brought by the Republicans we put in charge.
3
For once a full-throated condemnation of the GOP from Brooks - What took so long? You couldn't see this coming for the past seven years?
1
It appears that the Washington D.C. republicans are so dead set on erasing anything with the name Obama attached to it they are willing to sell their own soul to do so, as well as selling their own constituents down the river.
If there is a good side to all this rancor it's that it is waking up people like David Brooks to what they have been voting for and that maybe, just maybe Obamacare was not so bad after all.
Could Obamacare be improved? Well sure, it could have been Universal Single Payer, but I have a feeling it will be a cold day Honolulu before republican pass that.
If there is a good side to all this rancor it's that it is waking up people like David Brooks to what they have been voting for and that maybe, just maybe Obamacare was not so bad after all.
Could Obamacare be improved? Well sure, it could have been Universal Single Payer, but I have a feeling it will be a cold day Honolulu before republican pass that.
Since the "Health care bill" is not that, but only a tax cut for the the poor wealthy, why is the press wasting ink discussing its failings to provide health care? It's not a health care bill! It's a tax cut! Why isn't that the focus of the discussion?
ELITIST Legislation, more colorfully called "trickle down" since the times of Ronnie Ray Gun, has not acted as an incoming tide to float all the boats. Sunk most boats, more like, it did. The 1% already earns most of the new wealth in the US. What more do they want? Are the rest of the 99% supposed to go on an orchid's diet--water, air and sunlight?
1
The Trump-don't-care bill is an another example of unholy alliance between religious and right wing extremists. For them people who cannot afford health care should get charity support in the nearest church. None of them realizes that universal health care (and universal education) are the matter of national security, not of entitlement or privilege. How can we defend ourselves or compete in global markets if our young people are too sickly and semi-literate to operate sophisticated military equipment? Large proportion of volunteers to military are being rejected for that reason already. Only universal, single payer, mandatory insurance is urgently in national interest (and be financially sustainable). What do oligarchs in republican party know about it? I have lived and used such type of medical coverage in other (civilized) countries and it works! The mobs of republican base will realize that when the lose their insurance but then it will be too late.
1
Today's comment from GOP Rep.Phil Roe of Tenn. "was that we have been working toward this health bill for 7 years", and now have a bill that best suits this nations health needs. That alone exhibits the pathological thinking that is now the republican party, a party led by a pathological president. If 7 years in the making and if this congressman's assessment can be understood correctly, the GOP once again proves to be the party against the best interest of the American people. It's been just a short half century ago when opposing political opinions could somehow reach consensus passing legislation for the countries benefit.
This health bill is not of donald's making, it belongs to Rep. Paul Ryan, and donald's only interest is that something gets passed for him to take credit for. If today it fails passage donald will have someone to blame, Paul Ryan, again exposing the political pathology existing within the republican party.
This health bill is not of donald's making, it belongs to Rep. Paul Ryan, and donald's only interest is that something gets passed for him to take credit for. If today it fails passage donald will have someone to blame, Paul Ryan, again exposing the political pathology existing within the republican party.
1
Doesn't your commentary support the progressive argument that it's the conservatives who are viciously indifferent to the problems the nation faces? Name another political party that draws its "inspiration" from the novels of a crackpot and whose leading spokesmen are scientific illiterates.
1
This is what happens when the chief "policy wonk" predicates his policy on the work of a second-rate fiction writer's utopian vision.
This is what happens when a political party allows itself to decide how you win and who wins in your name doesn't matter. Only winning counts.
Paul Ryan's belief in Ayn Rand's dream world leads him to place markets ahead of what is marketed. Donald Trump's ignorance of governance and disdain for the common good lead him to grab anything that presents the hope of "winning".
The GOP is fractured. Perhaps beyond repair. I see no one in the party to lead it toward a reorganization that it so gravely is in need of.
This is what happens when a political party allows itself to decide how you win and who wins in your name doesn't matter. Only winning counts.
Paul Ryan's belief in Ayn Rand's dream world leads him to place markets ahead of what is marketed. Donald Trump's ignorance of governance and disdain for the common good lead him to grab anything that presents the hope of "winning".
The GOP is fractured. Perhaps beyond repair. I see no one in the party to lead it toward a reorganization that it so gravely is in need of.
3
On Sept 2016 you wrote "It will be hard to govern after a campaign about nothing." , and I doubt at the time you thought the country would have Republicans ruling congress and filling the presidency.
I believe the campaign was about something, and even then it was clear what the differences between the candidates were. The current healthcare debate is just a bunch of assassins discussing how lethal they want to be in killing the victim. When total repeal of Obamacare is more beneficial than this healthcare farce, it's clear this bill is poison, meant only as tax relief for the rich. Trump will just run down the to-do list, check off "accomplished" and declare victory. Then the Republican wrecking crew will move down to the next item on the list.
As long as they have big money donors to pay for the public brainwashing bill they can sleep tight.
I believe the campaign was about something, and even then it was clear what the differences between the candidates were. The current healthcare debate is just a bunch of assassins discussing how lethal they want to be in killing the victim. When total repeal of Obamacare is more beneficial than this healthcare farce, it's clear this bill is poison, meant only as tax relief for the rich. Trump will just run down the to-do list, check off "accomplished" and declare victory. Then the Republican wrecking crew will move down to the next item on the list.
As long as they have big money donors to pay for the public brainwashing bill they can sleep tight.
2
Repeal and Replace has become lie and obfuscate. The Republicans have once again shown their lust for money and their craven disregard for the very people who elected them. If ever there was a need for an educational system that taught students how to differentiate between honesty and a lie it is now. How can our country survive when the electorate is so easily fooled by a pack of liars and snake oil salesmen and women masquerading as responsible politicians? Sadly this is the face of a once great political party. Our nation's survival is in jeopardy.
5
It's a Russian thing, an authoritarian thing, a totalitarian thing.
Ayn Rand, the hero of Paul Ryan, was all about the pain you can inflict on others in the name of Self.
Stalin was all about the use of enforcement apparatus for enforcement and punishment. Trump is a wonderful totalitarian in that regard. ICE is merely his first use of the apparatus. T-party primary challenges are this weeks enforcement apparatus.
The GOP doesn't care about Americans, or even care about the GOP, they care about ....what? Yes, guns and religion and exploiting the poor and the working class.
Ayn Rand, the hero of Paul Ryan, was all about the pain you can inflict on others in the name of Self.
Stalin was all about the use of enforcement apparatus for enforcement and punishment. Trump is a wonderful totalitarian in that regard. ICE is merely his first use of the apparatus. T-party primary challenges are this weeks enforcement apparatus.
The GOP doesn't care about Americans, or even care about the GOP, they care about ....what? Yes, guns and religion and exploiting the poor and the working class.
1
Trump doesn't care about the details, just the perception of a "win". His mistake was leaving the plan to Ryan and his minions. There's a lot of Ayn Rand, Ryan's muse, in the plan. It's also an incredible mess. But it will pass the House because they need to repeal the ACA. Trump, Ryan, etal will declare "victory." At least for now.
1
It's only fitting that the republican congress give the Trumpites what they have been asking for, a replacement plan for Obamacare.
Trumpcare , if passed in any of the current forms being described, would be the poetic justice Trump's supporters so richly deserve. They've been clamoring for a clobbering and their elected officials are giving them what they've been asking for. There will be no sympathy when they wake up to find out what's in store for them. Their great savior is not the benevolent father figure who will save them.
This is only the beginning. Medicare and Social Security are coming up on the agenda. Soon the genius voters will have given away everything, and they will feel great again.
Trumpcare , if passed in any of the current forms being described, would be the poetic justice Trump's supporters so richly deserve. They've been clamoring for a clobbering and their elected officials are giving them what they've been asking for. There will be no sympathy when they wake up to find out what's in store for them. Their great savior is not the benevolent father figure who will save them.
This is only the beginning. Medicare and Social Security are coming up on the agenda. Soon the genius voters will have given away everything, and they will feel great again.
3
Donald Trump is not interested in policy or substance and only wants to "win"?
The Republican's don't have real people, life-based prescriptions for how to help Americans get better quality healthcare at lower cost, and amidst all the noise and misdirection will remain fixed on their orthodoxy: cutting taxes (for the wealthy and corporations), gutting social safety net programs, and removing any and all regulation?
Who would have imagined...
The Republican's don't have real people, life-based prescriptions for how to help Americans get better quality healthcare at lower cost, and amidst all the noise and misdirection will remain fixed on their orthodoxy: cutting taxes (for the wealthy and corporations), gutting social safety net programs, and removing any and all regulation?
Who would have imagined...
1
The Republican way of health care:
I have mine, you can just suffer and die.
I have mine, you can just suffer and die.
1
If the Republicans dubbed the Affordable Care Act as "Obamacare," let's call this version AsIfWeCare.
5
There hasn't been substance in the Republican Congress in the last several years. Expecting things to change now is wishful thinking.
I always believed that having a two party system was a good thing for the country, but the last 8 years has proven me wrong. Will someone please start another party?
By the way, Republicans have always come across as the party of MEAN. They could care less about the average person.
I always believed that having a two party system was a good thing for the country, but the last 8 years has proven me wrong. Will someone please start another party?
By the way, Republicans have always come across as the party of MEAN. They could care less about the average person.
2
Republicans no longer know how to fashion a bill that helps regular people. They have been caught up in cutting taxes for the rich and businesses since Reagan, even though it has yet to create jobs. In short they do not care about people. The article mentions tax credits and HSA's as being helpful, they are when you have the money to fund them, but most workers do not make enough to get an advantage of the tax credits or to have extra cash to put in the HSA. The fact that they are making concessions to the hardcore haters to get them to vote for the bad plan shows who counts in their lives - the insurance companies. This is not healthcare. I hope the moderate republicans (I was surprised there still are some) hold their ground. Was the ACA perfect, no. But republicans never wanted to fix the few things wrong with it, spend millions talking about its bad points and 7 years doing nothing but repeal, repeal, repeal. Now after working on this for about a month, they think this will fix healthcare. Let's take away their healthcare and let them deal with the free market. Insurance is only expensive for the people who do not get help from their employers. My healthy husband is 63, he spends $700 a month for a policy that pays nothing until you hit an incredible deductible and has to have $9000 in an HSA to even get that policy. Only one more year and he can join me on Medicare, unless of course the republicans take that away and turn it into a voucher.
1
Isn't it about time for you now, Mr Brooks, to switch camp and join the good guys who always try to help the little people, i.e. the Dems. Why is it that the Dems are always stuck with fixing the mess that the GOP leaves behind (the Iraq war, the massive Reagan-Bush deficit etc...) and when they try to fix things, the GOP works arduously to prevent them from doing so. I haven't seen anything from the GOP in the past 25 years that actually helped the US population other than making their buddies even more rich.
4
The best form of delivering health insurance in this country will be a hybrid system. Universally mandated insurance comes in many forms, from national health service, private for profit insurance, private non profit insurance, all payer, single payer etc. Mr. BRooks the private market cannot do it alone, fie on your stupid health savings accounts, and idiotic risk pools( like yachts, a hole in the water in which to,throw money ).
This shameful, sadistic, and cynical play by the really awful people your party has put in power, truly made us shed tears last night as we watched it last night. People will be truly harmed. My contempt knows no bounds.
This shameful, sadistic, and cynical play by the really awful people your party has put in power, truly made us shed tears last night as we watched it last night. People will be truly harmed. My contempt knows no bounds.
1
Trump and the current Republican Leadership have and will lie to get what they want. Then they will lie more to keep it. And still more to day people are not really dead. And their Constitution is New and Better.
No insurance and then no education... big military. It's a plan alright and we should be fighting every minute.
4
Sounding a bit Democratic aren't we David?
1
The Who (a Rock Group) wrote about this a long time ago in a song called "Won't Get Fooled Again." It ends "meet the new boss, same as the old boss" It probably say meet the new boss, worse than the old boss.
1
"...the most vicious progressive stereotypes about conservatives and validates them."
Substitute "accurate" for "vicious" and you'd be closer to a workable reality. All else that needs be done is to substitute "extreme right-wing conservatism" for straightforward (traditional) "conservatism" and the validation would be complete.
There was once a time when the political/ideological struggle between liberals and conservatives consisted of honest disagreements and mutual respect. As a lifelong liberal, I have no thoughtless, hidebound quarrel with the rational concepts of traditional conservatism, even while mostly opposing it. The struggle was of the kind over which "reasonable people could disagree".
But what's going on now is the rise of "vicious" extreme right-wing conservatism, characterized by the very stereotyping of liberals you seem to ascribe to them vis-à-vis conservatives.
I don't like it that liberals have been pushed in the direction or fighting fire with fire due to the successes of decades-long simplistic propaganda forwarded by extremist conservatism, but there seems to be little choice in what's become a political/ideological knife fight, thanks to the "viciousness" of extremism from the right.
And that's too bad.
Substitute "accurate" for "vicious" and you'd be closer to a workable reality. All else that needs be done is to substitute "extreme right-wing conservatism" for straightforward (traditional) "conservatism" and the validation would be complete.
There was once a time when the political/ideological struggle between liberals and conservatives consisted of honest disagreements and mutual respect. As a lifelong liberal, I have no thoughtless, hidebound quarrel with the rational concepts of traditional conservatism, even while mostly opposing it. The struggle was of the kind over which "reasonable people could disagree".
But what's going on now is the rise of "vicious" extreme right-wing conservatism, characterized by the very stereotyping of liberals you seem to ascribe to them vis-à-vis conservatives.
I don't like it that liberals have been pushed in the direction or fighting fire with fire due to the successes of decades-long simplistic propaganda forwarded by extremist conservatism, but there seems to be little choice in what's become a political/ideological knife fight, thanks to the "viciousness" of extremism from the right.
And that's too bad.
5
Kudos to David Brooks for reminding the public of exactly what is going on with the rush to have a "win" for Trump and his sycophants. This is likely a blueprint for how Trump will negotiate- his way or no way. There is ignorance about policy proposals and little concern for our most vulnerable citizens - the goal is to be declared a "winner". . Trump is temperamentally unable to bring consensus and foster cooperation for the common good; his forte is to create adversaries and pit people against each other, to create "winners" and "losers". Looks like he is succeeding in turning the House of Representatives and the Senate into Opponents. Sad and dangerous.
1
Cut-throat misanthropy on parade, and the worst is that it's "vapid"?
I was struck by this sentence: "They could have drafted a bill that addressed the perverse fee-for-service incentives that drive up health costs, or a bill that began to phase out our silly employment-based system, or one that increased health security for the working and middle class."
I agree with Mr. Brooks that these are excellent policy goals. But Obamacare (to its discredit) did nothing to address them. If you enacted a law to repeal the ACA and successfully address all those policy goals, you would still be left with the basic problems Obama and the Democrats actually set out to solve: How to insure people with pre-existing conditions on the private market. How to make premiums more affordable for the most vulnerable. How to make sure your insurance will actually cover you when you get sick.
None of those policy goals - Mr. Brooks' or Obama's - is addressed by the Republican bill. Nor do they have anything to do with "health savings accounts, tax credits and competitive health care markets to drive down costs." The former two are meaningless to people whose cash flow and tax bracket make them the targets of Mr. Brooks' alleged policy goals, and the last reflects a fundamental misunderstanding of how people shop for health care. (Hint: They don't. When you're sick, you do what your doctor tells you.)
By floating his lofty vision by completely inadequate means, Mr. Brooks demonstrates that he is part of the problem.
I agree with Mr. Brooks that these are excellent policy goals. But Obamacare (to its discredit) did nothing to address them. If you enacted a law to repeal the ACA and successfully address all those policy goals, you would still be left with the basic problems Obama and the Democrats actually set out to solve: How to insure people with pre-existing conditions on the private market. How to make premiums more affordable for the most vulnerable. How to make sure your insurance will actually cover you when you get sick.
None of those policy goals - Mr. Brooks' or Obama's - is addressed by the Republican bill. Nor do they have anything to do with "health savings accounts, tax credits and competitive health care markets to drive down costs." The former two are meaningless to people whose cash flow and tax bracket make them the targets of Mr. Brooks' alleged policy goals, and the last reflects a fundamental misunderstanding of how people shop for health care. (Hint: They don't. When you're sick, you do what your doctor tells you.)
By floating his lofty vision by completely inadequate means, Mr. Brooks demonstrates that he is part of the problem.
"Politics driving substance, not the other way around," this is news?
Where were you during the last eight years when Republican legislation was driven by one overriding concern, stymying the Democrat in the White House?
Elites are all about elites, old or new, this new crew maybe more vapid, but unfortunately just as calculating and avaricious.
Where were you during the last eight years when Republican legislation was driven by one overriding concern, stymying the Democrat in the White House?
Elites are all about elites, old or new, this new crew maybe more vapid, but unfortunately just as calculating and avaricious.
3
The half-baked health care bill is more than just a ping pong game between the two sides of the aisle in Congress. It is more than a struggle between the Executive and Congress or between evidence and logic, with the Judiciary waiting on the sidelines. If Congress caves in and passes a terribly flawed health care reform, Trump will proclaim victory and the U.S. health care system –and health of the U.S. population- will continue to disintegrate. If Congress rejects the bill, a deeply unhappy President was respond in worrisome ways that are beyond prediction.
Either way there are storm clouds ahead for U.S. democracy. This administration is nothing less than a stress test on the fundamentals of American democracy, and on the notions of truth and evidence in policy making. Every one of the signers of the U.S. Constitution, and long-gone supporter of the Bill of Rights must be turning restlessly in their grave. This has to be seen as a test, not just of political will on this or that policy or piece of legislation, but a stress test on the fundamentals of American democracy itself.
Either way there are storm clouds ahead for U.S. democracy. This administration is nothing less than a stress test on the fundamentals of American democracy, and on the notions of truth and evidence in policy making. Every one of the signers of the U.S. Constitution, and long-gone supporter of the Bill of Rights must be turning restlessly in their grave. This has to be seen as a test, not just of political will on this or that policy or piece of legislation, but a stress test on the fundamentals of American democracy itself.
4
Besides having a dangerously incompetent[ President . it seems he is matched by the GOP leadership in the House , especially Paul Ryan and Devin Nunes. Both should resign.
1
republicans that claim to have opposed ObamaCare actually opposed the former President, not the bill. It's not a new elite, it's the same heartless bunch.
I emailed these lines from Mr. Brooks' column to my congressman, Minnesota Third Congressional District's Erik Paulsen. The congress needs to hear from the folks they represent.
"It would cut Medicaid benefits by $880 billion between now and 2026. It would boost the after-tax income for those making more than $1 million a year by 14 percent, according to the Tax Policy Center. This bill takes the most vicious progressive stereotypes about conservatives and validates them."
"It would cut Medicaid benefits by $880 billion between now and 2026. It would boost the after-tax income for those making more than $1 million a year by 14 percent, according to the Tax Policy Center. This bill takes the most vicious progressive stereotypes about conservatives and validates them."
2
"Amusing" isn't it, to watch this out-of-touch, lap-dog Congress flounder around in what is more an exercise in preserving their cushy jobs (with all those lovely health care benefits and other attendant perks) and their amours propres then a real effort to take care of the best interests of their constituencies. And, of corse, the Occupier in Chief assumed that he could continue on with his usual pattern of having no real solutions to anything but ride along on the coat tails of others who appear to have ideas (misguided and misanthropic as they are) so that he can devote his working hours to tweaking nonsense, insulting major portions of the US and world populations and posing for photo ops. To borrow a word from the OIC, "Sad".
1
Question for David Brooks: How do "health savings accounts ... drive down costs"?
1
It is refreshing that partisan politics is no longer a problem in Washington. It's just Republicans against Republicans. Bad ideas vs. worse ideas. Democrats must be enjoying the internecine warfare, waiting for the Republicans to mortally wound each other. Which they will. Each believing that they are truly right about what is so fundamentally wrong.
1
Trump pushed this evil Obamacare thing through his entire election cycle, and Ryan since its inception. All have been demeaning it without mush accountability. Why now, at the eleventh hour, almost after the fact, is the media finally focusing on it? Letting the players get away with lies leads to disaster and puts our whole government at risk.
The final paragraph is on point but understates the problem. The president is an empty vessel - all attitude and no substance.
There is an interesting parallel to a candidate from the past, namely Ross Perot, also a wealthy businessman with no gov experience, strongly opposed to NAFTA.
The difference ends there, however. When during a debate Perot was asked a question to which he did not have an answer, his response was that he would convene a panel of experts and figure it out. There was at least an honest acknowledgment and a reasonable, if not ideal response that feels qualitatively different than "We'll have something wonderful" with all kinds of empty and contradictory promises to follow and a bill completely drafted by others.
Which brings us to what is unique about Trump as president - his overweening intellectual laziness, and the fact that his negotiating skills are really a joke. He can "negotiate" by stonewalling desperate students defrauded by his university and stiffing contractors and investors. His attempt to "negotiate" amongst his party's factions yesterday amounted to a little of cutting the baby in half followed by an ultimatum. Real negotiation over challenging issues requires a level of creative intellectual engagement. It's hard work, more so than tweeting.
There is an interesting parallel to a candidate from the past, namely Ross Perot, also a wealthy businessman with no gov experience, strongly opposed to NAFTA.
The difference ends there, however. When during a debate Perot was asked a question to which he did not have an answer, his response was that he would convene a panel of experts and figure it out. There was at least an honest acknowledgment and a reasonable, if not ideal response that feels qualitatively different than "We'll have something wonderful" with all kinds of empty and contradictory promises to follow and a bill completely drafted by others.
Which brings us to what is unique about Trump as president - his overweening intellectual laziness, and the fact that his negotiating skills are really a joke. He can "negotiate" by stonewalling desperate students defrauded by his university and stiffing contractors and investors. His attempt to "negotiate" amongst his party's factions yesterday amounted to a little of cutting the baby in half followed by an ultimatum. Real negotiation over challenging issues requires a level of creative intellectual engagement. It's hard work, more so than tweeting.
I don't understand why otherwise brilliant people like David Brooks can't understand that market forces don't really apply to healthcare. You can't negotiate while you're unconcious in the back of an ambulance. You're not going to check rate charts at a variety of urgent care centers while you're bleeding out. It just doesn't work. If there is one drug that will save your life you can't simply pass on it. If there is one doctor in your rural town, that's the doctor you have to go to... and he can set his rate with your insurance company.
Market forces only apply in functional markets where purchases are fundamentally optional. Every optional procedure/visit in medicine isn't particularly expensive as it is and market forces already apply. That isn't what drives healthcare costs.
The best way to drive down costs in healthcare is to either regulate how much doctors/hospitals/pharmecuticals can charge for certain procedures or create a massive single payer insurance market that can effectively do the same thing by shifting power away from providers.
If you are absolutely insistent on the need for market forces to drive down costs, than it is a standard supply/demand problem that health savings accounts can't fix. Since you can't effect the demand portion (roughly the same number of people are going to get sick) than you have to change the supply. Perhaps vastly expand medical schools or allow pharmicist to conduct basic tests and write some prescriptions/etc.
Market forces only apply in functional markets where purchases are fundamentally optional. Every optional procedure/visit in medicine isn't particularly expensive as it is and market forces already apply. That isn't what drives healthcare costs.
The best way to drive down costs in healthcare is to either regulate how much doctors/hospitals/pharmecuticals can charge for certain procedures or create a massive single payer insurance market that can effectively do the same thing by shifting power away from providers.
If you are absolutely insistent on the need for market forces to drive down costs, than it is a standard supply/demand problem that health savings accounts can't fix. Since you can't effect the demand portion (roughly the same number of people are going to get sick) than you have to change the supply. Perhaps vastly expand medical schools or allow pharmicist to conduct basic tests and write some prescriptions/etc.
Yes, the American health Care {Denial] Act is a Frankenstein monster composed of toxic body-politic parts about to be let loose in a murderous rampage to satisfy the President who narcissism requires a "win" and Paul Ryan who wants to kill off Medicaid as an entitlement. The political myopia and the havoc are staggering and truly frightening.
How much money is Donald Trump using to buy votes?
GOPCO = political arm of corporate and rich America
1
A good piece, Mr. Brooks - let's hope the "old, vapid Republican elites" read it and say "no" to this clueless "marketing guy" and his administration, and this cruel, vanity bill that has nothing to do with improving the lives of Americans.
Trump's history as a developer is building gold-plated condos for the rich and casinos named "Taj Mahal" for the poor. The condos are still open while the casinos are closed. He's got the same approach to America.
1
Your words that the plan "would increase suffering" is so telling. Shouldn't government's role be to lessen suffering among its citizens? Every Republican needs to ask themselves if they care if anyone suffers from not having adequate health care, then act accordingly. We will be watching to see what their answer is.
Why would anyone be surprised that Trump abandoned his absurd, sweeping unrealistic campaign promises, particularly his pledge of better, cheaper health care for all? This is an individual who cares for no one but himself and a win and how people could not see through this during his campaign and buy into his rhetoric is beyond me. He has no understanding of the struggles of middle class and poor Americans, except for an uncanny ability to convince people that he does. Now that he's in the White House, he's shown that he is most definitely not a president for everyone, as he claimed during his victory speech on election night. His endorsement of the reckless, poorly executed sham of a health care bill just to make a political point was predictable.
"I like savings accounts, tax credits and competitive markets to drive down costs". When will you and your like understand that health care neither can nor should be handled as a marketed commodity. Motor vehicle or house insurances maybe. But in the realm of healthcare nobody should seek to reduce costs in order to increase profits for the various stakeholders in this domain. It invites exactly the kind of unthinking, uncaring, and greedy "negotiation" happening right now in DC, and is unworthy of the democratic principles of the country.
However, given that this fundamental situation will not change soon, the best the country can hope for right now is a temporary collapse of all this hyper active nonsense, followed by a more sober and systematic review and improvement of the current legislation by some of the undoubtedly more competent, less partisan, and genuinely motivated members of both House and Senate, led neither by the current Speaker nor President until a decent proposal is made.
However, given that this fundamental situation will not change soon, the best the country can hope for right now is a temporary collapse of all this hyper active nonsense, followed by a more sober and systematic review and improvement of the current legislation by some of the undoubtedly more competent, less partisan, and genuinely motivated members of both House and Senate, led neither by the current Speaker nor President until a decent proposal is made.
How can an intelligent man write in the same column that he wants to eliminate perverse fee for service AND prefers free market solutions. healthcare is no more free market than police services, or road rebuilding. Obamacare is a first stepin the long process to national healthcare, the only solution that can affect the cost of medicine, because it is the only solution to fee for service care. The market has already spoken, fee for service is the "death spiral' and I speak as a practicing physician.
every single time i read a news story about donald trump's utter unsuitability for the presidency, i'm cheered a bit, as if there's another glimmer of reality shining through the malaise. still, there's that teenage impulse to say, duh! after all this is the man who chanted, lock her up. there's hardly anything left to say. we could just as well watch a repeating loop of trump's maiden voyage down the escalator.
Please point the way to a significant piece of GOP sponsored legislation that is not built from the top down?
1
David Brooks: "I opposed Obamacare. I like health savings accounts, tax credits and competitive health care markets to drive down costs." Why don't you and others who favor a market-based healthcare plan just model one after some successful ones already in place around the world?
Oh! Now I remember why you don't. There are none!
Oh! Now I remember why you don't. There are none!
713
"I like health savings accounts", Brooks? As you ask about Trump you might wonder what might be wrong with your attitude and bias (facts) because your're just another, "I am opposed to Obamacare" do nothing GOP deadbeat. Healthcare is simple and there are dozens of government models to pick from and implement. This country amasses and spend for military might beyond all reason and a poor person cannot get care in West Virginia. The GOP is evil and sold their soul to the devil.
12
The Republican's will pass this bill solely for the purpose of being re-elected. No other reason.
9
Unqualified doesn't even begin to describe the unbelievable level of lazy mindedness and incompetence that grows ever more evident with each passing day. Combined with his unprecedented ego and lack of emotional maturity, the mediocrity of this young Trump presidency even shocks those of us who predicted that he would fail at the job. It's all simultaneously stunning and worrisome.
27
Once again when the Republicans had the chance to do something right-they go right ahead and shoot themselves in the foot. This and the other pieces of legislation that the Republicans propose and will propose simply lay the foundation for a Democratic takeover of the both houses and the Presidency.
They simply vote themselves out of office.
They simply vote themselves out of office.
10
If this clown car of supposed leaders is the best Republicans can come up with oh lord are we in for a mess.
17
Ought legislation address the problems of the voters or the problems of the elite?
Wrong Question, David. Governance is first and foremost not about "solving problems." It is about channeling aspirations - the aspirations of a people: what kind of society do we want to line in; how do we want to ensure the common welfare; how do we want to facilitate its growth and prospering? If it is not first about aspirations and only about "problem-solving," then it is an empty exercise that goes nowhere.
This abomination of a GOP health care bill is a perfect example of what happens when legislation is about solving a problem -- in this case a political problem. There is no guiding aspiration underneath that articulates how this will promote the health and well-being of a people - it's just not there, despite the rhetoric. As with any legislation that simply tries to solve a problem or get us out of a jam, it will create even more problems and unintended consequences that will need to be solved at a latertime (with solutions that will create even more problems and unintended consequences). And the cycle will go on and on.
No, this is not about the difference between the problems of voters and the problems of the elite. This is about the difference between statesmen/stateswomen and hacks. Sadly, the AHCA debacle exposed the hacks - in droves.
Wrong Question, David. Governance is first and foremost not about "solving problems." It is about channeling aspirations - the aspirations of a people: what kind of society do we want to line in; how do we want to ensure the common welfare; how do we want to facilitate its growth and prospering? If it is not first about aspirations and only about "problem-solving," then it is an empty exercise that goes nowhere.
This abomination of a GOP health care bill is a perfect example of what happens when legislation is about solving a problem -- in this case a political problem. There is no guiding aspiration underneath that articulates how this will promote the health and well-being of a people - it's just not there, despite the rhetoric. As with any legislation that simply tries to solve a problem or get us out of a jam, it will create even more problems and unintended consequences that will need to be solved at a latertime (with solutions that will create even more problems and unintended consequences). And the cycle will go on and on.
No, this is not about the difference between the problems of voters and the problems of the elite. This is about the difference between statesmen/stateswomen and hacks. Sadly, the AHCA debacle exposed the hacks - in droves.
16
Trump needs a win. He doesn't care how he wins, he needs a win so he can continue feeding his fawning crowd at the rallies. He doesn't care if Trumpcare guts the healthcare for the very people he promised to give a gold-plated, beautiful healthcare. After all he has stiffed many of his workers that stiffing people has become second nature to him. He doesn't care if he has to bully the GOP members in the Congress on his way to a win. After all he bullied his way to the White House. He assigned derogatory names to each of his opponents and whipped up his crowd into a frenzy.
And, if this bill becomes law, he'll continue feeding folks at his rallies the same miasma even as they think it is manna. I am beginning to be less worried about Trump's antics and more worried about the people who continue to see him as their savior. We need a new song "Please cry for me America."
And, if this bill becomes law, he'll continue feeding folks at his rallies the same miasma even as they think it is manna. I am beginning to be less worried about Trump's antics and more worried about the people who continue to see him as their savior. We need a new song "Please cry for me America."
13
The government we have is a reflection of the people that we are. It was voted into office by people who support the policies that were presented to them by the elected officials who compose the governing bodies, and by the people who did not vote just as much as by those who did. Of the 350,000,000 citizens of this country, those of legal voting status made their choice of who to vote for or not. The appalling ignorance of the voting population of this country is horrifying but real. The instillation of a professional governing class has taken the duty of the governing officials to represent the best interest of the people who voted for them and replaced it with doing what is in the best interest of the elected officials. This has led to the unbalance of power between the investor wealthy class and the working class. Campaign financing is far easier when you only have to appeal to a few instead of the many, so who are you going to represent. The investor wealthy class has become the focus of our governance, and we are to blame for allowing this to happen. Both Mr. Obama and Mr. Sanders were able to finance a campaign supported by mostly small donors. The reason Mr. Sanders is not now our president is because too many who should have supported him chose not to vote. Instead, the belligerent, ignorant, self-righteous, came out in force to support a belligerent, ignorant, self-righteous candidate, this mess is our fault as a people disunited.
10
You can't blame Trump. He's in way over his head, he has no clue what being president is about. Pity poor Donald, for having landed a job he is incapable of doing. And pity his voters, for having purchased a pig in a poke.
12
The goals are 'optics'.... and power... 'Obamacare' is the sideshow.
trump, with the help of analytics and fake-news media, provides the optics... loaded down with negatives, hate and lies
'They' study us to exploit our weaknesses, and thus they exploit, ruthlessly, the weakest among us.... so far it has worked.
but the other goal, in service to some very sick billionaires, is to hurt the many in service to the few, and to pull the string of the 'puppets' that the rest of us call citizens.
This is pure evil, with a healthy dose of insanity.
To defeat it it must be rejected IN ITS ENTIRETY.... and by 'it' I mean the G.O.P., owned, operated, and populated by the most cynical politicians in several generations, in service to power.
So, please David, stop looking for the slivers of reason ('Obamacare isn't perfect', for instance)....
Obamacare is the sideshow.....
The snake's head is in full view... replete with golden locks...
The G.O.P. must be destroyed.... COMPLETELY....
This is our Sacred and a Patriotic duty... this is the apocalyptic struggle... this is endtimes....
trump, with the help of analytics and fake-news media, provides the optics... loaded down with negatives, hate and lies
'They' study us to exploit our weaknesses, and thus they exploit, ruthlessly, the weakest among us.... so far it has worked.
but the other goal, in service to some very sick billionaires, is to hurt the many in service to the few, and to pull the string of the 'puppets' that the rest of us call citizens.
This is pure evil, with a healthy dose of insanity.
To defeat it it must be rejected IN ITS ENTIRETY.... and by 'it' I mean the G.O.P., owned, operated, and populated by the most cynical politicians in several generations, in service to power.
So, please David, stop looking for the slivers of reason ('Obamacare isn't perfect', for instance)....
Obamacare is the sideshow.....
The snake's head is in full view... replete with golden locks...
The G.O.P. must be destroyed.... COMPLETELY....
This is our Sacred and a Patriotic duty... this is the apocalyptic struggle... this is endtimes....
11
All the republicans have to do is RENAME and REPARE Obamacare.
13
To paraphrase - "You're doing a heck of a job Trumpy". We all know how that turned out for the folks in New Orleans.
16
"I like health savings accounts, tax credits and competitive health care markets to drive down costs."
Health savings accounts and tax credits only work if people have jobs that pay a sufficient amount of money so that they can afford to use some of that money for saving, tax credits work only if they earn a taxable income, and competitive health markets have never driven down costs because competition isn't the thing that drives the cost of health care in this country -- it's services that drive the costs -- doctor fees, hospitals, medical equipment, etc.
Please get over the typical Republican idea that "competition" is the answer to everything when it answers nothing other than who scores more points in game.
I'm also sick of the GOP-generated mantra that the ACA, etc. is socialized medicine. ALL insurance is a form of socialism -- a large pool is formed by people paying in for protection should they need to use the resources of the pool ie. the many pay for the few who need to use the service. Homeowner's, renter's, auto, etc. -- that's how insurance works. Not everyone will use the resources but all will be protected in the event that they do. It's simple -- only the GOP has attempted to make into a "communist, Marxist, socialist" plot when it come to health insurance. The concept of insurance has been understood since the day of the coffeehouses when men pooled their money to "insure" wooden ships and their cargos -- only the GOP doesn't "get" the concept.
Health savings accounts and tax credits only work if people have jobs that pay a sufficient amount of money so that they can afford to use some of that money for saving, tax credits work only if they earn a taxable income, and competitive health markets have never driven down costs because competition isn't the thing that drives the cost of health care in this country -- it's services that drive the costs -- doctor fees, hospitals, medical equipment, etc.
Please get over the typical Republican idea that "competition" is the answer to everything when it answers nothing other than who scores more points in game.
I'm also sick of the GOP-generated mantra that the ACA, etc. is socialized medicine. ALL insurance is a form of socialism -- a large pool is formed by people paying in for protection should they need to use the resources of the pool ie. the many pay for the few who need to use the service. Homeowner's, renter's, auto, etc. -- that's how insurance works. Not everyone will use the resources but all will be protected in the event that they do. It's simple -- only the GOP has attempted to make into a "communist, Marxist, socialist" plot when it come to health insurance. The concept of insurance has been understood since the day of the coffeehouses when men pooled their money to "insure" wooden ships and their cargos -- only the GOP doesn't "get" the concept.
120
Only 46 more months.
When I read these pieces, these comments and see what's going on I must ponder why just about half of America votes for these people, the GOP. This health care bill is a great example of them doing nothing to help the Average American, in fact it hurts them, and to what end? To give the 1% a tax cut, to keep the far right quiet, to show they can stamp out President Obama? Why, oh way would an average American vote for these people???
49
And this lack of sensitivity to voters' needs and ineffectual, substance-free leadership (DJT) will persist if we don't reconsider how we choose our presidents. That seemingly endless process culminating in an electoral-college win favors a "marketing guy" and reality-show star who entertains viewers and makes money for cable news outlets. Maybe we should repeal and replace that!
28
"I like health savings accounts, tax credits and competitive health care markets to drive down costs."
This just goes to show you know little about health economics.
I'm a medical doctor, not an economist, but I'm aware that S cholarly research has demonstrated over and over again what anyone like me with exposure to the healthcare industry gradps intuitively: normal market forces don't apply to medical care.
This just goes to show you know little about health economics.
I'm a medical doctor, not an economist, but I'm aware that S cholarly research has demonstrated over and over again what anyone like me with exposure to the healthcare industry gradps intuitively: normal market forces don't apply to medical care.
44
We've seen what Republican "elites" are from the past forty years of failed policies and fiscal mischief to incompetence, starting with "trickle down."
What puzzles me, David, is that you continue to sell your party, without realizing that it's time for you to switch horses and apologize for your past mistakes.
What puzzles me, David, is that you continue to sell your party, without realizing that it's time for you to switch horses and apologize for your past mistakes.
29
If the vicious stereotype fits: wear it
15
I live in Canada but spend a significant amount of time in the US. . I want the absolute best for the US but can't fathom the options you are discussing with healthcare.
I was born with a genetic disorder (ADPKD) that led to Kidney failure. Declining health with final kidney failure, dialysis... I received a Live donor transplant 2.5 weeks ago. I spent a week in the hospital and read probably 100 articles on the US healthcare debate.
How the American people can't see healthcare as the most important RIGHT I don't understand? All men are created equal. What better way to put that into practice than taking care of its citizens and their families?
Universal healthcare in Canada is not perfect but it is nothing like the lies that Republican lawmakers espouse. This is not just a Trump issue, Ryan and all the rest are complicit. They cherry pick facts and twist them. 50,000 Canadians go to the US for healthcare (so 99.8% get it in Canada). Over the last 5 years I have received nothing but world class healthcare. I received a complicated ABO incompatible transplant in Toronto that only a select group of hospitals in NA could do. I was in a Transplant ICU with 3 other patients. I am in the top 10% of income and two of the other patients were clearly in the bottom 30%. We received IDENTICAL care. All created equal. I am doing fantastic with $0 copay and am focusing on ONLY getting better. How would those poorer people fair in the new US healthcare system. Sad.
I was born with a genetic disorder (ADPKD) that led to Kidney failure. Declining health with final kidney failure, dialysis... I received a Live donor transplant 2.5 weeks ago. I spent a week in the hospital and read probably 100 articles on the US healthcare debate.
How the American people can't see healthcare as the most important RIGHT I don't understand? All men are created equal. What better way to put that into practice than taking care of its citizens and their families?
Universal healthcare in Canada is not perfect but it is nothing like the lies that Republican lawmakers espouse. This is not just a Trump issue, Ryan and all the rest are complicit. They cherry pick facts and twist them. 50,000 Canadians go to the US for healthcare (so 99.8% get it in Canada). Over the last 5 years I have received nothing but world class healthcare. I received a complicated ABO incompatible transplant in Toronto that only a select group of hospitals in NA could do. I was in a Transplant ICU with 3 other patients. I am in the top 10% of income and two of the other patients were clearly in the bottom 30%. We received IDENTICAL care. All created equal. I am doing fantastic with $0 copay and am focusing on ONLY getting better. How would those poorer people fair in the new US healthcare system. Sad.
1084
Universal Health Care.
America spends roughly 18% of GDP on healthcare with poor results. The next closest is France at 12% of GDP with better health, more benefits for women and families, better outcomes.
When did it become American to pay more and get less? You would think conservative, money conscious people would understand simple math.
America spends roughly 18% of GDP on healthcare with poor results. The next closest is France at 12% of GDP with better health, more benefits for women and families, better outcomes.
When did it become American to pay more and get less? You would think conservative, money conscious people would understand simple math.
32
The health insurance industry is a leech on the public body, plain and simple. Every cent that goes into the pocket of insurers is paid for by unnecessary sickness and death of someone on the other end. The very definition of blood money.
18
If the core of Obamacare is gutted, death panels is the unintended consequence. If that is the case, the least this new plan can do is provide for ice flows.
1
Obamacare should be improved not repealed and replaced. Before Obamacare 50 million had no health insurance and the costs of health care were rising rapidly. According to RAND, nearly 17 million more Americans have health care than before Obamacare. It has produced other major benefits and can be made even better. Replacing it makes no sense. The democrats could help prevent its repeal by acknowledging its current deficiencies and showing that they can be readily corrected, as proposed below. This message should be urgently conveyed to the public by them as well as AARP, AMA, ANA, and other organizations and leaders supporting the ACA.
As it stands now, Obamacare’s goals cannot be fully met. There has been a sharp rise in premiums to make participation feasible for insurers because the pool of persons seeking insurance in the exchanges is smaller and less healthy than anticipated. These deficiencies, currently exploited by the G.O.P. in its efforts to repeal it, can be eliminated by removing their root cause: failure of the individual mandate to encourage younger and healthier Americans obey the law and buy insurance. The mandate could become a powerful enforcement mechanism either by drastically increasing the penalty for not subscribing or by making participation in the program mandatory.
As it stands now, Obamacare’s goals cannot be fully met. There has been a sharp rise in premiums to make participation feasible for insurers because the pool of persons seeking insurance in the exchanges is smaller and less healthy than anticipated. These deficiencies, currently exploited by the G.O.P. in its efforts to repeal it, can be eliminated by removing their root cause: failure of the individual mandate to encourage younger and healthier Americans obey the law and buy insurance. The mandate could become a powerful enforcement mechanism either by drastically increasing the penalty for not subscribing or by making participation in the program mandatory.
6
Unfortunately, the replacement plan is a con job extraordinaire..
6
I never thought I'd live to see the day when I agreed with most, or indeed any, of a column by David Brooks. Is it possible deep down he's actually a decent guy, and is repelled by the total breakdown of any kind of integrity or decency we're currently witnessing in the American political arena?
I do disagree on "free market solutions". Health care isn't the kind of commodity where people can act as "enlightened consumers", shopping around for the "best buy" and comparing prices. In fact, it shouldn't be treated as a "commodity" at all. And competition doesn't drive prices down; health care costs far more in the US than in any other developed county. Only a publicly managed, single-payer system can keep costs down: in other words, Medicare for all.
But then, I live in Finland. Anu Partanen had a good column about our health care system in the Times a few days ago.
I do disagree on "free market solutions". Health care isn't the kind of commodity where people can act as "enlightened consumers", shopping around for the "best buy" and comparing prices. In fact, it shouldn't be treated as a "commodity" at all. And competition doesn't drive prices down; health care costs far more in the US than in any other developed county. Only a publicly managed, single-payer system can keep costs down: in other words, Medicare for all.
But then, I live in Finland. Anu Partanen had a good column about our health care system in the Times a few days ago.
25
The documentary of today's republicans is entitled "Mean and meaner."
6
Mr. Brooks, the bill they are going to ram thru today is based on three, and only three assumptions...1) The rich need and deserve more tax cuts 2) The poor must be punished for being 3) Everything Obama must be erased. Nothing, nothing at all, matters more.
This is not leadership. This is not governing. This is not normal....except it is all that Republicans do and have done for the last 8 years. And since Reagan, assumptions 1 and 2 have been the operative assumptions for everything.
This is not leadership. This is not governing. This is not normal....except it is all that Republicans do and have done for the last 8 years. And since Reagan, assumptions 1 and 2 have been the operative assumptions for everything.
14
Although I am well to the left of you on most issues, increasingly I appreciate your articulate and well reasoned expression of what should be the policy of the Republican Party. Of course, as you have said, you do not share the views of the current Republican Party, which consist of a bizarre melange of Tea Party, Freedom Coalition, Koch Brothers, Paul Ryan and -- above all-- Trump "priorities". These are the people in power. As an atheist all I can say is " God help us".
Burr Henly
Burr Henly
4
In order for the Times editorial page to maintain the appearance of balance, between those who support the use of birth control ( Dems) and those opposed to the use of birth control (GOP) David Brooks' column, should be written by Presidential advisor, Kelly Ann Conway, until the demagogue Trump, is either impeached, or resigns ( which is likely to occur, regardless)
1
Of course Trump wants to get past Obamacare, that's just for show. He can make real money by eliminating [his] taxes, such as the AMT. Only losers pay taxes to support this country and president Trump is a winner!
7
"Vicious progressive stereotypes about conservatives" only exist, David, because they are true. Answer this please: Besides the unfunded Medicare Part D prescription plan Republicans supported to ensure pharmaceutical companies would face no cost containment legislation (and to win support from older white voters), please name one or more major pieces of legislation Republicans have championed in the last 20 years that have widely benefited the working and middle classes and not enriched the wealthiest Americans.
To call a truthful characteristic "vicious" is like calling a person of dignity and character a "nasty woman."
To call a truthful characteristic "vicious" is like calling a person of dignity and character a "nasty woman."
15
The unpopular populism of Trump and the Republican party is an unstable oxymoron that has not imploded yet because a solid majority of Republican voters continues to support Trump. Until this foundation gives we will be living a demolition wrecking ball in excruciatingly slow motion. America should never have been caught in this situation, this is the Berlin wall falling on this side of the world.
If there's anything good about this, it's the lesson Americans are being given about what it means to be a Republican in 2017: what Republican values are, how they "govern," what their level of competence is, and what happens if you ever vote for them.
You don't have to be a political junkie to learn this lesson. And people are learning it: polls about the AHCA show even lower support as soon as you tell people it comes from Republicans.
You don't have to be a political junkie to learn this lesson. And people are learning it: polls about the AHCA show even lower support as soon as you tell people it comes from Republicans.
4
On healthcare, the Republican Party has actually morphed into two parties. Group One are moderate and represent, to a certain extent, the old guard, steeped in limited government, strong military, and restraint in spending. Group Two, is full of Tea Party types and other hard right folks. Any government run healthcare is bad, but if you must have it, vouchers, and policies with high deductibles and limited minimum care requirements will suffice. This group is like an old car, assembled out of spare parts, some that barely work, and others that are obsolete. As far as repealing Obamacare or the ACA, the differences are between the two groups are irreconcilable.
2
As a healthcare provider, I find the GOP's 'solution' deeply disturbing. It seems so obvious that they don't care about the American people. This healthcare proposal won't hurt me or my family: we have a generous employee-paid health insurance package. However, it hurts my chronically ill patients and the middle class and poor the most. Despite who my patients voted for, they deserve what I have and nothing less, even if it means higher taxes for me. Am I that unique? How can such a large swath of Republicans vote for making people sicker and poorer?
Welcome to another day in Wonderland. Today, I find myself rooting for the Freedom Caucus -- which I hate -- to defeat the Trumpdontcare bill.
Oh, and David, you say: "This bill takes the most vicious progressive stereotypes about conservatives and validates them." Have you ever thought that maybe these aren't stereotypes but rather true descriptions of core values?
Oh, and David, you say: "This bill takes the most vicious progressive stereotypes about conservatives and validates them." Have you ever thought that maybe these aren't stereotypes but rather true descriptions of core values?
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The con is finally being glaringly revealed to those who insisted that a "bona fide businessman" had the interests of the average working men and women of America at the top of his agenda.
Two of Trump's bombastic lines resonate today:
"I alone can fix it," and "who knew healthcare was so complicated?"
Two of Trump's bombastic lines resonate today:
"I alone can fix it," and "who knew healthcare was so complicated?"
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David Brooks, maybe you can write a column and explain to us how the heck health care and/or insurance can work in a free market economy. The commodity is too precious to each of us, and the richer you are, the less people want equality of service for all people. Since I was 7 years old, this flaw that life is worth too much to most of us to make sense of a free market health economy.
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“This bill takes the most vicious progressive stereotypes about conservatives and validates them.” I’m guessing that someone once said something very similar to that in 1789, except that it was in French, right before the Bastille was stormed. David, Trump’s alleged “populist revolt” is pure nonsense, the REAL revolt hasn’t quite started yet but at this rate it will arrive sooner than later – and you and your friends are not going to like it.
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Well, this is what Republicans voted for. As a Democrat, I guess I should say "thanks" though. I'm not going to lose my insurance and it looks like I'll get a tax cut to boot.
Please recall Mr Reagan's six most terrifying words: "I'm from the government and I'm here to help".
Under the Trump administration hasn't it become true....
Under the Trump administration hasn't it become true....
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Mr. Brooks puts too much faith in “competitive health care markets” and other “free-market reforms.” The history of the business model has too many cases of deception, obfuscation, and profiteering to be trusted to give Americans more affordable basic healthcare. If CEO salaries and the ads that run ad nauseum on television are any indication, the profit motive at any cost drives the pharmaceutical industry. When life and health are on the line, a messy, unreliable system of competition (dominated by greed) is totally inappropriate. We have the ACA, which has helped people. Let’s keep and improve it!
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I am saddened to think that a man like Mr. Ryan, who comes from a lower middle class background, would sell his soul to the devil for power. I hope his power grabbing will come back to bite him in the next election.
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Welcome to our world, David! The only way to do what the Republicans said they wanted to do, cover more people for less money, is to have a single payer system that cuts out the private insurance industry. Until we all understand that insurance is, of it's nature, going to support the neediest while being paid for by all, we will continue this horrible charade. The thing is, you never know when you will be the beneficiary.
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Brooks naively offers, "I like health savings accounts, tax credits and competitive health care markets to drive down costs.". He might have added, "unicorns and leprechauns" while he was at it. There is no such thing as a competitive health care market. Healthcare costs have risen at more than three times the rate of inflation, decade after decade. For economists, that is the defining characteristic of an noncompetitive market. The vast majority of Americans have exactly one hospital to choose from. When someone is sick, there is no "shopping around for a good deal". If your daughter breaks her arm playing soccer, you don't check the sales flyers or find a discount coupon. Pharmaceutical companies and device manufacturers operate as cartels, with patents and licensing deals protecting their products and pricing from competition.
The healthcare market is a monopoly. Most western nations understand this, and have turned to single payer systems to protect consumers. Mr. Brooks and his conservative brethren live in "free market" fantasy land, and it's time they accepted reality and stopped chasing rainbows.
The healthcare market is a monopoly. Most western nations understand this, and have turned to single payer systems to protect consumers. Mr. Brooks and his conservative brethren live in "free market" fantasy land, and it's time they accepted reality and stopped chasing rainbows.
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Time for technocrats to take over important things.
(Unfortunately, politicians - nor others - ever cede power voluntarily).
(Unfortunately, politicians - nor others - ever cede power voluntarily).
If the president were the great deal maker he calls himself, he would go to the Democrats who have the larges voting block and say, "Let's do single payer." The approach he promoted when running for office. If he did that he'd come out smelling like a rose, but alas.
5
Mr Brooks you are right on with this opinion piece. The GOP so called healthcare bill has nothing to do with providing affordable care that actually contains measures in it that provide coverage, in fact the only thing it does is provide premium payments to insurance company who in turn supply no benefits to the purchasers. The bill is really a huge tax break for the wealthy.
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What we need is a rebellion of the moderate Republicans who have no other choice now but to defect and form a new party in the middle that can equally draw from Democrats who have become disaffected from their rabid left wing.
Only requirement: That only rational people are permitted in that party.
Only requirement: That only rational people are permitted in that party.
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Moderate Republicans? What moderate Republicans? I wish there were some, but many of the challengers in the primaries are white, right-wing extremists.
It is still absolutely mind-boggling how so many Americans fell for Donald Trump's "I'm-one-of-you" act.
They thought he meant it. They thought he was different.
He would be a much needed "change" from the old status-quo elite.
How did they think a pathological swindler whose only concern is himself, could "change" anything?
Well, they're seeing it now.
But they'll be paying for it later.
They thought he meant it. They thought he was different.
He would be a much needed "change" from the old status-quo elite.
How did they think a pathological swindler whose only concern is himself, could "change" anything?
Well, they're seeing it now.
But they'll be paying for it later.
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David's column hit the nail on the head. The Republican health care bill is all about ego and hubris. Trump and the Republican House wanted to claim a win in the worst way possible--and that's what we're getting: the worst possible bill.
This would all be amusing theater if the actors on the stage just stabbed each other in the back. Unfortunately its the audience who are the victims. What the Fools on the Hill fail to comprehend is that this is not a play--this is real life and lives are literally at stake.
Shame on the Republicans--not just for the latest bill but for seven years of trying to scuttle expansion of health care for those who can least afford it.
This would all be amusing theater if the actors on the stage just stabbed each other in the back. Unfortunately its the audience who are the victims. What the Fools on the Hill fail to comprehend is that this is not a play--this is real life and lives are literally at stake.
Shame on the Republicans--not just for the latest bill but for seven years of trying to scuttle expansion of health care for those who can least afford it.
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Free market reforms can not make health care better or keep down prices. Healthcare is not like buying a TV set or purchasing a car. Universal insurance coverage mandated by law and enforceable cost control is the only way to guarantee access and quality. On top of that there should be mandated cradle to grave education about diet and lifestyle choices. Sounds reasonable? In this hyper capitalist country it will never happen. Doctors,fast food,junk food producers,hospital owners,private insurers and everybody else that stands to lose out if America gets healthy will never let true reform happen.
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There are people in this country crying every day. All they. want to do is live a life while facing enormous challenges in a unfriendly world. We are a great country but we have forgotten why we were great in the first place.
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Thanks, David, for another great article. I worry about the collision of the trend toward automating jobs and the Republican dogma that penalizes the poor and unemployed. We have already lost about 3.5% of US jobs to automation. As self-driving vehicles replace truck, taxi, and other drivers, we’ll lose 3.5% more, over 10 million jobs in total. Carrier reportedly plans to take the money it received from Donald Trump and, instead of moving to Mexico, automating its US factory and minimizing human jobs. Yet Republicans have no plans for how to feed, house, and take care of these millions of displaced workers. Instead of attacking a growing problem, they prefer peeling away current subsistence benefits, like healthcare, from the unemployed and transferring the savings to the affluent business owners who are doing the automating. The automation revolution is projected to end with 90% of US jobs obliterated. Even if we reverse course and move back toward income redistribution, it’s hard to imagine any system that can effectively provide a living for these vast numbers of the unemployed. But we're not even trying!
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“But with this bill the Republican leadership sets an all-time new land speed record for forgetting where you came from.”
The Republicans haven’t forgotten from where they come. They come from the place that protects the interests of millionaires and billionaires. They can, with a straight face and no shame, propose legislation that guts services for poor and middle class families while offering massive tax breaks to the wealthy. Their deep concerns for the poor surface every two years, around election season, when they make promises that they have no intention of fulfilling. Now that they are in charge, it will be much harder to disguise their true colors.
The Republicans haven’t forgotten from where they come. They come from the place that protects the interests of millionaires and billionaires. They can, with a straight face and no shame, propose legislation that guts services for poor and middle class families while offering massive tax breaks to the wealthy. Their deep concerns for the poor surface every two years, around election season, when they make promises that they have no intention of fulfilling. Now that they are in charge, it will be much harder to disguise their true colors.
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"phase out our silly employment based system."
This is a righteous goal of health care reform. No one ought to be shackled to a job they hate because they or someone in their family needs health insurance to pay for health care.
I say and say again that healthcare is a universal human right. The world has said so in the Universal Declaration of Human Rights. Thus, as our own Declaration of Independence holds, governments exist to secure our unalienable rights.
Healthcare ought not to be subject to the profit motive, and it is something that we ought to provide for one another. Yes, the healthy pay for the sick because we are fragile human beings, and we all one day will be sick or need preventive care.
Single payer Medicare for all paid for with a Value Added Tax.
If Trump is the deal maker he claims to be, he will work with the Dems to make it happen.
This is a righteous goal of health care reform. No one ought to be shackled to a job they hate because they or someone in their family needs health insurance to pay for health care.
I say and say again that healthcare is a universal human right. The world has said so in the Universal Declaration of Human Rights. Thus, as our own Declaration of Independence holds, governments exist to secure our unalienable rights.
Healthcare ought not to be subject to the profit motive, and it is something that we ought to provide for one another. Yes, the healthy pay for the sick because we are fragile human beings, and we all one day will be sick or need preventive care.
Single payer Medicare for all paid for with a Value Added Tax.
If Trump is the deal maker he claims to be, he will work with the Dems to make it happen.
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How much of it could be paid for if all the employers and employees paid income tax equal to what they now pay for medical insurance? I'd think that would be a large boost. VATs tend to be regressive.
1
"I am the president and you're not" - the very definition of elitism.
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It's now become much more sharper in focus that much of the opposition to Obamacare is rooted in racism. This was the standard Republican approach to healthcare, after all, previously named after Mitt Romney--by today's standards, a dying Republican.
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The reason the pieces of so-called "policy" in this so-called "healthcare bill" can be shifted around without regard for coherence and without regard for their terrible effects on the American people is that this is not and never was a healthcare bill. It's a tax cut bill. That's the one part of the bill that has stayed constant because that's the only thing that Ryan, Trump, and their ilk are really interested in. And like all Republican tax cuts, the benefits go mostly to wealthy people like Ryan and Trump. They just want money for themselves, no matter what happens to the rest of us.
3
Again, there is a top end to what someone will pay for a bottle of wine, there is a top end to what someone will pay for a car, there is no top end to what someone will pay to live. 'The free market driving healthcare costs down' is a myth. The Government must cap them or they will never be capped.
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Thank you for this!
David says of the Reppublicans:"They could have drafted a bill that addressed the perverse fee-for-service incentives that drive up health costs, or a bill that began to phase out our silly employment-based system, or one that increased health security for the working and middle class." He's describing the ACA.
I think your characterization of the causes of the poor quality of the Republican proposal is spot on.
It is interesting to see that Obamacare had to be massively and unfairly badmouthed to become nominally unpopular (death panels anyone?). The current Republican proposal seems to sink under its own weight -- and deservedly so because it is not only bad and would drive up both medical expenses and mortality at the same time, but is also wantonly cruel to Americans who are not wealthy.
The Republicans should understand that people do not want to buy insurance, they want to be able to buy medical services, and the insurance is but a means to get there. You will never improve a product by making the tools to obtain it worse. Just making insurance cheaper while increasing the outlay to each individual is not what people want to buy.
It is interesting to see that Obamacare had to be massively and unfairly badmouthed to become nominally unpopular (death panels anyone?). The current Republican proposal seems to sink under its own weight -- and deservedly so because it is not only bad and would drive up both medical expenses and mortality at the same time, but is also wantonly cruel to Americans who are not wealthy.
The Republicans should understand that people do not want to buy insurance, they want to be able to buy medical services, and the insurance is but a means to get there. You will never improve a product by making the tools to obtain it worse. Just making insurance cheaper while increasing the outlay to each individual is not what people want to buy.
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"This bill takes the most vicious progressive stereotypes about conservatives and validates them." David, I am most glad to read you finally see the GOP for what they really are.
First, do no harm.
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" This bill takes the most vicious progressive stereotypes about conservatives and validates them."
Or, perhaps, these stereotypes are not vicious, nor are they actually stereotypes. Instead, maybe they are appropriate characterizations of a vicious GOP leadership. It is just that, with control of the administrative and legislative branches and pending control of the judicial branch, the GOP leadership has set aside the pretense that they care about any but themselves and the rich they serve.
Or, perhaps, these stereotypes are not vicious, nor are they actually stereotypes. Instead, maybe they are appropriate characterizations of a vicious GOP leadership. It is just that, with control of the administrative and legislative branches and pending control of the judicial branch, the GOP leadership has set aside the pretense that they care about any but themselves and the rich they serve.
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People rather glibly say that Congressional representatives and Senators should be paid only a dollar. That's unrealistic. It would be more of an education, a way of reminding them where they came from, to pay them the Median Household Income as a reminder of what their constituents have to live on. Maybe if they had to squeeze out health care copayments from that sum, they'd come closer to understanding what needs to be part of health care legislation rather than tax cuts for the wealthy.
"...you’d think that at least somebody would be interested in listening to the people.". It has been many years since that, the listening to the people, has taken place in those hallowed halls of Lobbyists and Pandering Politicians.
Thank you for clarifying so much of the past two months' confusion, I can't imagine the hardship this would have caused for millions of our citizens. Thank God it didn't carry the vote.
Having not read the bill with all March 23rd trade-offs, I have no pro or cons, yet. If you are a commenter, have you read the actual bill as stands for the 3/24 vote, after all the changes, or like me not had the opportunity? Also, as a commenter, how many of us have a full understanding of the "Byrd Rule." Those of us who do not, need to update ourselves, as I have, so as to understand what all the networks mean when referring to the "Byrd Rule." It gave me a different perspective in doing so.
What do you expect from a man who is used to getting the building built no matter what deals he had to make? He is unconcerned with the underlying foundation because he is going to spackle over it and gold leaf it anyway. Appearance is everything and substance is nothing. We are in the darkest period of American history that I can remember and the sun is still going down.
I am struck by the hypocrisy of the Republican leadership on the Hill. They have criticized (wrongly) Obama and the Dems for rushing through the ACA behind closed doors in the dark of night --- and yet, as DBrooks points out, that's exactly what they are doing - rushing "to commit to legislation even while major pieces of it were still in flux, when nobody had time to read it..." Watching the events of the last few days make me think these folks are lost in the wilderness on so many levels.
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The problem with Brooks, Trump, and the GOP is that universal health care is not a commodity or service to be offered on the free marketplace as other democratic civilized societies have long ago figured out.
It's an insurance product that covers everyone and works on the principle that the more people in the pool the more money to cover those who will need so the people through their governments pay.
This simple misunderstanding leads to GOP cries of tax credits, savings accounts, choice, and access to health insurance. That's what government is for to insure everyone; and it's cheaper and better. Contrast and compare US which is based on For Profit with other single payer systems. US costs are highest BUT not the health of the US people compared with other countries that have some form of single payer.
When will Brooks, Trump and the GOP ever learn?
It's an insurance product that covers everyone and works on the principle that the more people in the pool the more money to cover those who will need so the people through their governments pay.
This simple misunderstanding leads to GOP cries of tax credits, savings accounts, choice, and access to health insurance. That's what government is for to insure everyone; and it's cheaper and better. Contrast and compare US which is based on For Profit with other single payer systems. US costs are highest BUT not the health of the US people compared with other countries that have some form of single payer.
When will Brooks, Trump and the GOP ever learn?
2
This WEALTHCARE disguised as healthcare... the GOP historically has never attempted to even pretend to be concerned with the disinfranchised ... the immoral funneling of wealth to the wealthiest by these policy makers who shun the very constituents foolish enough to empower them is the cruelest joke of all. WAKE UP AND VOTE THESE FAT CATS BACK TO THEIR ROCKING CHAIRS!
2
Don’t bother reading the bill, just look at the marketing. Low-premium policies (that provide worthless coverage), insurance for people with pre-existing conditions (in exorbitantly expensive and unworkable high-risk pools), lower government spending (while uncovered primary care and emergency room costs burden the system). Yes, Republicans know well how to sell this tax-cut bill disguised as a health care plan. Can’t wait to see their efforts on the country’s other major issues.
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WIth luck, our accidental president Trump is going to do so much not winning, he'll get tired of not winning!
Very, very tired of it, and unhappy, and helplessly angry, until we can give him the boot.
Very, very tired of it, and unhappy, and helplessly angry, until we can give him the boot.
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Thanks for having the courage and the humanity to call this what it is- wealthcare! Trump and his cabinet certainly don't need more money. Trump is breaking all his campaign promises. No surprise to many of us. I love innovation, but American insurance and business greed is a sickness. It lacks humanity. Maybe Bill Gates will save us.
Yes, the Trump elite is awful, but the Trump voters, who elected this clown for president--one with little intelligence or compassion--are ultimately responsible for this mess. Voters, as it turns out, are not very wise, and those who failed to vote--many millenials-- have voted (or not voted) against their own interests, without, it seems, having the intelligence to understand that they have done so. They are going to reap what they sowed, and sadly, they are the ones who will suffer most.
Trump is early in his first semester of governing 101. One wonders if he will actually pass, fail or drop out. It's not looking good for him or the country so far.
What he learned in real estate doesn't translate well into governance. Profit has always been his main objective in life. Unless he and the rest of the republicans can craft legislation to improve the lives of all Americans they will fail.
Hopefully the current health care debacle is not a road map for future policies to come. If it is, the great country of America will be less great and Trump may have to change his major.
What he learned in real estate doesn't translate well into governance. Profit has always been his main objective in life. Unless he and the rest of the republicans can craft legislation to improve the lives of all Americans they will fail.
Hopefully the current health care debacle is not a road map for future policies to come. If it is, the great country of America will be less great and Trump may have to change his major.
1
While the Republican bill is horrible, there is some logic to it based on the legislative process. What Republicans were facing was a media that was focused on them not having a repeal for the ACA when they had been promising "repeal and replace" for years, and noting their hypocrisy for negotiating "behind closed doors" after criticizing Obama for doing the same thing. Both fair criticisms.
So it seems like the Republican leadership, in an even more top-down way than Mr. Brooks suggests, put together a bad bill to get something through the House, so that the Senate could then pass another, different bad bill, so that they could then go into a conference committee to hammer out what would become the real bill. Thus the Republican leadership could negotiate behind closed doors without the criticism of it being behind closed doors because it was just part of the legislative process.
Ultimately, the bill they negotiated in conference would then be offered to all Republicans for an up or down vote ultimatum. Normally, I expect this maneuver would work, but health care is too high profile, and even this early vote could be held against them in elections later.
So it seems like the Republican leadership, in an even more top-down way than Mr. Brooks suggests, put together a bad bill to get something through the House, so that the Senate could then pass another, different bad bill, so that they could then go into a conference committee to hammer out what would become the real bill. Thus the Republican leadership could negotiate behind closed doors without the criticism of it being behind closed doors because it was just part of the legislative process.
Ultimately, the bill they negotiated in conference would then be offered to all Republicans for an up or down vote ultimatum. Normally, I expect this maneuver would work, but health care is too high profile, and even this early vote could be held against them in elections later.
Yes, it is all true. Nevertheless, the nation continues, the Constitution lives, and Americans will not be dying in the street. This proposal will not become law. The Senate will stop it, and there will be deadlock on the issue, which will mean that Obamacare will die a natural death resulting form its own inherent flaws. Then the Democrats and Republicans will have no choice but to come together and pass a law that works. The outlines of such a law have always been fairly obvious, but have been obfuscated by politics on both sides. First, no pre-existing condition restrictions. Second, require all states to achieve 95% catastrophic health care coverage to qualify for any federal funding of healthcare. Third, provide states block grants to incentivize healthcare coverage. Fourth, make all health insurance portable, break down all barriers to buying insurance across state lines. Fifth, provide preventive healthcare to the poor through Medicaid. Sixth, healthcare costs not covered by catastrophic insurance or Medicaid for the poor or Medicare for the elderly will be born by the consumer, thus providing downward pressure on healthcare inflation. The economic purpose of insurance is to cover catastrophic costs, not routine ones. Our system is broken because we refuse to acknowledge this.
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Maybe just maybe, the "deplorables" will come to see that the disdainful Democratic elites had en elitism based on intelligence, competence and, infuriating arrogance aside, genuine compassion and a sense of fairness.
Maybe those Democratic elites will begin speaking to the entire country and will no longer view anyone as deplorable - even those with views that meet the definition of the word.
Maybe everything will be fine.
Maybe those Democratic elites will begin speaking to the entire country and will no longer view anyone as deplorable - even those with views that meet the definition of the word.
Maybe everything will be fine.
I believe Trump doesn't want this health bill to pass. Then he'll blame weak Republicans for its failure, but it will keep obamacare intact.
I agree about this new bill. But I just read the Tax Policy Center report, and I think your numbers are wrong.
Brooks says he likes "competitive health care markets to drive costs down." That only works if there's significant oversupply among the vendors providing the service. Low barriers to entry for more efficient providers and elastic demand help too. In healthcare, there is neither but many conservatives have the misconception all it takes is "more competition" and point to Lasik operations and cosmetic surgery as examples where the "free market" worked miracles (Lasik is a simple, non-invasive procedure and cosmetic surgery is not cheap).
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Top-down legislation can work---if the people on the top understand the fundamental principles of the legislation they are crafting. I am astounded that Rep. Ryan, supposedly the party intellectual, still doesn't understand how insurance works ---insurance companies are designed to make money, not to lose money---insuring everyone in this country, from an actuarial perspective---is a loser--it is that simple. So, here are your options: kick health losers off of the rolls or subsidize those same health losers. The Republicans, caught up in an ideological joyride, are doing the opposite--they are kicking health losers off the rolls and at the same time subsidizing those who already have good insurance. I still don't get the Trump voter---some voter in West Virginia will kicked off the rolls, and me, with great insurance and a good salary, I'm going to get a rebate---unbelieveable.
Your editorial misses the point entirely that the U.S. is devoting too much of its national income to medical care. At one out of every six dollars of GDP, an American family of four earning $60K should expect to pay $10,000 per year for health insurance and out of pocket medical expenses. No amount of income redistribution or slick marketing can change that fundamental fact, so let's start tackling root causes rather than symptoms. Other nations pay a fraction of what we pay per person and yet achieve superior medical results. Perhaps we could swallow our pride in American Exceptionalism long enough to discover what works elsewhere and then pick one of those solutions.
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I agreed fully with the first part of this column, especially the difference between the views of "insiders" and "outsiders." But then my enthusiasm waned. Health care is not a free-market issue, because the "free market" - in its current iteration - is all about profit, with an attention to product that is only sufficient to maintain a customer base: which when it comes to healthcare is universal.
I have grown weary listening to praise for American exceptionalism, and to boasts about us being the richest country in the world, while also being aware that we are the only industrialized nation in the world that cannot provide universal health coverage. I agree with Harvey Cox: the "Market Is God" and too many of us are willing to be living sacrifices to be offered up on the altar of greed and profits.
I have grown weary listening to praise for American exceptionalism, and to boasts about us being the richest country in the world, while also being aware that we are the only industrialized nation in the world that cannot provide universal health coverage. I agree with Harvey Cox: the "Market Is God" and too many of us are willing to be living sacrifices to be offered up on the altar of greed and profits.
The best thing that could happen for our country now would be the passage of this bill, both in house and senate, and signed into law. Only then will the devastating effects be born out, especially to those who fail to understand what is going on. And only then will the party of "me" finally get their much deserved reward.
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Donald Trump has registered two relatively unremarked-upon successes: He has exposed the Republican mendacity and ill intent, while, at least temporarily, getting David Brooks to climb off his high horse.
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This chaos is what we get when a guy whose sole expertise is selling his "brand" becomes our so-called President.
A vengeful, unthinking minority has requested a vacuity to "lead" the nation, and their request has been fulfilled.
A vengeful, unthinking minority has requested a vacuity to "lead" the nation, and their request has been fulfilled.
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I'm glad you ultimately got around to mentioning the massive tax cut for the upper 2%. If getting Obama's name off of a healthcare program was issue One, the tax cut was easily easily issue One A. The arrogance of the Republican establishment, married to the ignorant arrogance of Trump is truly breathtaking.
It's also appalling that one of the reasons the AHCA will fail is because the so-called Freedom Caucus believes it doesn't cut benefits enough.
What kind of freedom is it that is defined by having the "access" to purchase something you can't afford? What kind of freedom is it to choose between food or medication? Only in some twisted mind where money matters more than life itself.
What kind of freedom is it that is defined by having the "access" to purchase something you can't afford? What kind of freedom is it to choose between food or medication? Only in some twisted mind where money matters more than life itself.
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In a normal political system, Republicans would be looking out for doctors, hospitals, and insurance companies. And Democrats would be looking out for their patients. The dividing line would be blurred, of course, but that would be roughly the dividing line.
In this case, Republicans are not looking out for doctors, hospitals, and insurance companies. The only patients Republicans are looking out for are the ones who were doing fine before Obamacare. The only true constituency Republicans now have are the international rich, the Paul Manaforts and Wilbur Rosses, who must be wooed with lower and lower taxes.
In this case, Republicans are not looking out for doctors, hospitals, and insurance companies. The only patients Republicans are looking out for are the ones who were doing fine before Obamacare. The only true constituency Republicans now have are the international rich, the Paul Manaforts and Wilbur Rosses, who must be wooed with lower and lower taxes.
Since when has the GOP ever been concerned with 'the least among us'? How quickly they forgot the arrogance displayed by Herbert Hoover as he sat silently as the USA fell into depression and the dust bowl. How quickly they became enraged at FDR's vision to view the USA as a single nation versus a confederation of states, each with veto power (the original intent of the Constitution) by way of his mitigating poor farming practices and removing inarable lands from farming, his rural electrification, the WPA, banking reform, and adeptly playing Stalin in WW2 so that Russia bore the brunt of casualties in the European Theater of Operations. The GOP's ideological bent of destroying the very fabric of the USA, in fact the original intent of the Constitution "in order to form a more perfect Union' is by any standard treasonous.
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"It’s no wonder that according to the latest Quinnipiac poll this bill has just a 17 percent approval rating."
And yet the party line is that Republicans had better vote for this repeal or they will get voted out of office. These "representatives" need to take a break from destroying the Affordable Care Act, go home for the weekend, and do some serious listening to their constituents.
And yet the party line is that Republicans had better vote for this repeal or they will get voted out of office. These "representatives" need to take a break from destroying the Affordable Care Act, go home for the weekend, and do some serious listening to their constituents.
1
There is a third way called middle out, where the concerns of those at the top and those at the bottom are the starting point. From there a solution and compromise can be worked out.
It is telling that in these times, this notion is not discussed or considered an option.
It is telling that in these times, this notion is not discussed or considered an option.
This is reminiscent of an early Laurel and Hardy talkie I saw once. The story revolved around two friends newly released from the hard life of a long Prison sentence. After the 10 or 20 years inside, the pair,(Laurel and Hardy-two of early talking films famous comedians), find that they are not "fitted" for life on the outside. They cannot get a job, there is nothing in the "new world" of the 1920's that seems to fit them. In the end, out of sheer desperation, hunger, need for a bed and somewhere and some authority to help them arrange their lives , so completely wrapped around the institutionalization of imprisonment, the pair break a shop window, set off the "alarm" and happily await the police and a further incarceration.
Right now, the congress and the GOP might feel like allowing the President's threat to be carried out would relieve them, like Laurel and Hardy, of the responsibility to act.
Inronically, most of the ACA,(affordable Care Act, passed during the Obama administration),was/ is a Republican designed system, originally the handiwork of GOP Governor Mitt Romney who originally designed the system for Massachusetts , when he ran the state. Trump could simply resume the old act, and call it Trump care. Congress would be relieved of any action and would be rescued by the handiwork of powerful and able political minds from an earlier era when pol's were proud of their handiwork. It make work poorly but at least it works!
Right now, the congress and the GOP might feel like allowing the President's threat to be carried out would relieve them, like Laurel and Hardy, of the responsibility to act.
Inronically, most of the ACA,(affordable Care Act, passed during the Obama administration),was/ is a Republican designed system, originally the handiwork of GOP Governor Mitt Romney who originally designed the system for Massachusetts , when he ran the state. Trump could simply resume the old act, and call it Trump care. Congress would be relieved of any action and would be rescued by the handiwork of powerful and able political minds from an earlier era when pol's were proud of their handiwork. It make work poorly but at least it works!
I always like David Brook's thinking and perspective and this editorial is no exception-well done. I must however comment on this falsehood permeating the health care discussion that the cost's are about insurance premiums. Health Care insurance is a cost plus product and 75%-80% of the premium is "the cost of claims". The way to manage health care cost is to look at the major drivers of claims- doctors , medical devices, drugs, mal practice cost's , administrative cost's , end of life plans all conribute to premiums. Only by addressing these items can we begin to have real impact on cost of health care. Having three insurance companies competing will make some small differences in the corporate market but it will not address our health care crisis.
David Brooks has focused in on the main issue that is neglected by Trump who wants to make a deal, the narcissistic politicians who want to be re-elected and the out of touch elite; that is the very real needs of people who are suffering and need health care to survive. Oh! May there be many more voices advocating for those lease fortunate among us.
I don't believe it is accurate to say that the Republican leadership in the Congress is visionless. One extraordinary valuable service that has been performed by the American Health Care Act is that it has clearly revealed both the Republican vision for health care which is that health care is a privilege that should be reserved for the healthy and wealthy. It has also clearly revealed the real priority of the party: massive tax cuts for the wealthiest Americans. And it has put on display the obvious hypocrisy of the favorite Republican argument against expanding (or preserving) coverage: first do no harm. This bill and a substantial number of both its supporters and opponents from the right are avid to do harm to millions of Americans.
It's being played like a game, rather than the serious business of American lives. I was already a Democrat, but just moved over two places to the left.
If I hear the phrase "free market forces" coming out of a Republican politician's mouth one more time I am going to scream.
If they are so bloody fixated on the concept, then can one of them explain why they specifically barred Medicare from using competitive bidding to buy drugs? They howl about the soaring cost of health care. They wail at the unconscionable hikes in prices for established meds like Epi-Pens, but as soon as it is suggested that "free market forces" would induce competition and lower costs, they go mute.
If they are so bloody fixated on the concept, then can one of them explain why they specifically barred Medicare from using competitive bidding to buy drugs? They howl about the soaring cost of health care. They wail at the unconscionable hikes in prices for established meds like Epi-Pens, but as soon as it is suggested that "free market forces" would induce competition and lower costs, they go mute.
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Start by taking away the very generous taxpayer funded health care for congresspeople. Then see how soon they support a single payer system!
Republican leadership has been lacking for decades. That they would think they have a 'mandate' after loosing the popular vote against a deeply-unpopular candidate, loosing two Senate seats and loosing six House seats is just bizarre. If the party had true leaders, they would have reached out to the opposition immediately after the election and forged a new path ahead., getting most of what they wanted.
Another way of looking at bottom up vs top down is to say that top down is electorate centered vs. political-powered centered. In a bottom-up approach, the President might see defection of his own Party as a red flag that his party's plan is not meeting the needs of the electorate. In a (narcissistic) top-down approach, of course, he simply bullies and threatens his party with retribution if they don't follow his lead.
What we have seen from the President in his first two months in office so far has been decidedly underwhelming. For a guy who sold himself on being strong, always right, and the consummate deal-maker, he has been decidedly ineffective. I guess it's that inconvenient learning curve, that unfortunately is a lot longer when you hire someone who has no previous relevant experience.
Can we now, once and for all, retire the canard that the best way to govern a country is to run it like a business? Or is it instead that we hired the wrong businessman?
What we have seen from the President in his first two months in office so far has been decidedly underwhelming. For a guy who sold himself on being strong, always right, and the consummate deal-maker, he has been decidedly ineffective. I guess it's that inconvenient learning curve, that unfortunately is a lot longer when you hire someone who has no previous relevant experience.
Can we now, once and for all, retire the canard that the best way to govern a country is to run it like a business? Or is it instead that we hired the wrong businessman?
I disagree with your statement that Capitol Hill lacks vision. It has had the same vision since Reagan:
1. Cut taxes for the wealthy.
2. Get rid of programs that benefit the lower and middle class.
3. Replace government employees with contractors.
4. Increase the national debt.
5. Attack and eliminate scientific research when it disagrees with the baseless beliefs of GOP constituents.
1. Cut taxes for the wealthy.
2. Get rid of programs that benefit the lower and middle class.
3. Replace government employees with contractors.
4. Increase the national debt.
5. Attack and eliminate scientific research when it disagrees with the baseless beliefs of GOP constituents.
And one more thing -- they can't run policy making from congress because the GOP decided ages ago that it won't pass anything unless the party votes for it as a block; the Hastert rule. So even though you could probably get some decent bills by letting centrists on both sides of the aisle work together the GOP leadership won't allow it. They've made governing impossible.
Maybe we should have mandated health insurance for major medical expenses while each individual American is responsible for everyday costs like doctor visits, shots, broken arms, etc., up to maybe $5000.00. Insurance to cover everything over that. This would have the effect of bringing down costs since so many people would not be able to afford even that level of expense. Costs go up when demand outpaces supply. We maybe should dispense with extras like psychological services or expensive elective surgeries.
The inhumanity of this legislation is beyond description and it speaks, sadly, to the nature of humanity within our government. In dealing with the most basic of human needs, those who control the switch, can think of nothing but the cost of that need while failing to recognize the fallacy of trying to provide it in a "for profit" environment, It simply cannot be done in such an environment. But those who profit from it in its present form will not allow a different environment to exist so that outcomes and not costs are paramount.
These excuses for humans, and they exist on both sides, never, never, never question costs when it comes to destroying human lives in foreign lands.
Mr. Obama, with all his warts, has been condemned for the ACA by his critics, but he should have been condemned with much more vigor for his failure to push for Medicare for all, which would have produced better outcomes for all Americans and whose cost would have been much more manageable. it works for seniors; it will work for all and it doesn't require any bombs or 54 billion in defense spending.
These excuses for humans, and they exist on both sides, never, never, never question costs when it comes to destroying human lives in foreign lands.
Mr. Obama, with all his warts, has been condemned for the ACA by his critics, but he should have been condemned with much more vigor for his failure to push for Medicare for all, which would have produced better outcomes for all Americans and whose cost would have been much more manageable. it works for seniors; it will work for all and it doesn't require any bombs or 54 billion in defense spending.
I don't know about "vapid" at least as applied to Paul Ryan. He, like the coreectly named Rand Paul, have a clear, simple and strong philosophy, or conviction anyway: taxes are theft. (Grover Norquist is another who holds this simple belief.) Beyond enough to pay for defense and for infrastructure that private enterprise or the states can't handle, any money taken by the government from those who earned it and given to people who did not, for what ever reason and to meet whatever needs, is simple theft. All that this bill is designed to do is to limit and lower that theft. All the mess of the bill's provisions, the contradictory rules and cutouts, are only absurd if the basic principle is missed: tax is theft. They could have simply repealed Obamacare -- but it may be that this bill gets them more tax "relief" than mere repeal.
Mr. Brooks, I do not often agree with you on politics, but this time you are spot-on!
Thank you for speaking up as one of a dying breed of moderate conservatives. The largest problem we face in DC is that there are no moderate conservatives willing to work on behalf of the people. We have elected a majority that is more ideological than pragmatic, and more interested in serving their donors' interests than those of the American people. The big question is: how do we get moderates back in office? Until then, I fully anticipate more legislation that overlooks the middle class in favor of the rich.
When diagnosed with prostate cancer I did not consider where can I get the best price but how do I find the best surgeon and hospital. Medical care is not a commodity that can be shopped for the best price. All of the anguish and machinations we are going through all point to a single payer system. An obvious conclusion all rich countries figured out long ago.
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Thank you David Brooks for a courageous expression of the truth. I don't know how America will prosper under this President, who really cares for nothing but his own ego.
Democrats know how to govern, but the don't know how to win elections.
Republicans know how to win elections, but they don't know how to govern.
Republicans know how to win elections, but they don't know how to govern.
Excellent liberal article--up to: "I like health savings accounts, tax credits and competitive health care markets to drive down costs." It is no surprise that Brooks is unaware of how little disposable income many Americans have, and of how useless savings accounts and tax credits are to them. Over and over, we've heard of pill splitting, of the hard choice between the rent and the meds, and of people just not bothering to see the doctor. Furthermore, the idea of competitive health care markets driving costs down is a shocking fiction given the history of American cartels and the history of health care costs over the last century. Remember, the Center for Medicare and Medicaid Services is expressly forbidden by law to negotiate the costs of meds with Big Pharma: the Bush gift that keeps on taking. When Ryan brings that up for repeal and replace, I'll look down from Heaven and say "Glory be..."
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When you say "This bill takes the most vicious progressive stereotypes about conservatives and validates them" I think you mean "This bill takes the most tenchant progressive observations about conservatives and proves them."
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The real question is not so much where all the clowns mentioned in this piece came from but more about who elected them.
With such a large segment of the populace about as vapid as their elected representatives, no wonder that this country is erasing its good name internationally at great speed.
Between corruption and low-level of expertise the ones undeservedly at the "top" are braking everything.
With such a large segment of the populace about as vapid as their elected representatives, no wonder that this country is erasing its good name internationally at great speed.
Between corruption and low-level of expertise the ones undeservedly at the "top" are braking everything.
Has any plan ever proposed by Paul Ryan not included large tax cuts for the wealthy?
If David Brooks thinks giving this process more time would have changed the outcome, he sorely mistaken.
If David Brooks thinks giving this process more time would have changed the outcome, he sorely mistaken.
Well, we've learned a lot about how bad the Tryan Bill will be substantively for folks and politically for the GOP?
Question is how much less bad will a retained "Obamacare" be for folks amidst Republican i can sabotage (no enrollments adds, no enrollment site upkeep, cuts PPACA tax funding)? Another is, whom will a hobbled ACA hurt more politically, the Republicans who won't fix it or the Democrats whose recent leader the bill still bears?
Question is how much less bad will a retained "Obamacare" be for folks amidst Republican i can sabotage (no enrollments adds, no enrollment site upkeep, cuts PPACA tax funding)? Another is, whom will a hobbled ACA hurt more politically, the Republicans who won't fix it or the Democrats whose recent leader the bill still bears?
The core Republican problem is this: Republicans arent good at governing the people because they dont care about the people.
While you're correct that this is a top-down bill "crafted by people who were insular and nearsighted," you neglected to mention that it was not only Republican elites whose interests are being served but also, even more so than with Obamacare, the insurance corporations that spend lavishly to ensure that the legislative process operates to cater to their unquenchable thirst for profits while ignoring the needs of average Americans.
And while you're correct that this bill is morally bankrupt, your own preference for "health savings accounts, tax credits and competitive health care markets" will only perpetuate the inefficiencies and gross distortions of our corporate-capitalist state. Until we break the stranglehold of the symbiotic relationship of corporate masters and congressional servants we will be stuck with healthcare that is, first and foremost, about creating and maintaining corporate profits.
The result will continue to be the most expensive, least efficient, and least equitable healthcare system in the world. Other countries have figured out healthcare much better than we have, and they provide models that we can learn from and build upon in order to, finally, construct a system that recognizes that healthcare should exist as a basic right of citizenship, not as a vehicle to be manipulated by corporations for profit.
And while you're correct that this bill is morally bankrupt, your own preference for "health savings accounts, tax credits and competitive health care markets" will only perpetuate the inefficiencies and gross distortions of our corporate-capitalist state. Until we break the stranglehold of the symbiotic relationship of corporate masters and congressional servants we will be stuck with healthcare that is, first and foremost, about creating and maintaining corporate profits.
The result will continue to be the most expensive, least efficient, and least equitable healthcare system in the world. Other countries have figured out healthcare much better than we have, and they provide models that we can learn from and build upon in order to, finally, construct a system that recognizes that healthcare should exist as a basic right of citizenship, not as a vehicle to be manipulated by corporations for profit.
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first time i've seen a piece regarding the health care bill that even mentions the messed up payment model that is a major driver of uncontrolled health care costs. FFS can be perverse, but what the large hospitals and health systems are doing to set their rates is a mugging. people blame drug companies (and they aren't innocent) but drug expenditures are still less than 15% of total health costs. they need to change up the payment system for medical services, no "health care" law will ever make a difference on costs to patients (whether through premiums, deductibles, OOP) until they address our whack payment model
Why are we not defunding the health insurance of our representatives?
I struggle with the theroretical concept of a free market in health insurance. If such a thing could exist, I think it would look a lot like what we had before the ACA. Massive numbers of people who couldn't buy the insurance coverage they needed because it was either too expensive or not available to them because of underwriting rules. In a few states a well run High Risk Pool filled some of the gap. It was a bad system that worked well mainly for the insurance companies.
Mr. Brooks says he “like[s] health savings accounts, tax credits, and competitive health care markets to drive down costs.”
1. HSAs might be of some marginal help to those who earn enough to pay their premiums AND have money left over from other living expenses to fund an HSA, but they’re of no benefit to the millions of us who can’t.
2. Obamacare already has tax credits, which are available to 83% of those who buy individual policies through the ACA markets. These tax credits are very helpful. For example, they pay 62% of the premium for my family (three persons, household income of about $75,000).
3. While “competitive health care markets” sound great and have that “free market”-y ring, our health care markets are decidedly NOT competitive, nor have I have ever seen any concrete proposals for how to make them so, not in our current system. Doctors and hospitals do not and will not compete on price for their services. Individual consumers simply cannot bring competitive pressures to bear on these inelastic suppliers. The most effective way to drive down costs is for the government (yes, the GOP’s great boogeyman) to be the single payer setting reimbursement rates in a Medicare system applicable to everyone. And if the government sets the reimbursement rates for the entire health care system, then doctors and hospitals who protest by refusing to accept Medicare patients (a now-common refrain) will find themselves without any patients at all.
1. HSAs might be of some marginal help to those who earn enough to pay their premiums AND have money left over from other living expenses to fund an HSA, but they’re of no benefit to the millions of us who can’t.
2. Obamacare already has tax credits, which are available to 83% of those who buy individual policies through the ACA markets. These tax credits are very helpful. For example, they pay 62% of the premium for my family (three persons, household income of about $75,000).
3. While “competitive health care markets” sound great and have that “free market”-y ring, our health care markets are decidedly NOT competitive, nor have I have ever seen any concrete proposals for how to make them so, not in our current system. Doctors and hospitals do not and will not compete on price for their services. Individual consumers simply cannot bring competitive pressures to bear on these inelastic suppliers. The most effective way to drive down costs is for the government (yes, the GOP’s great boogeyman) to be the single payer setting reimbursement rates in a Medicare system applicable to everyone. And if the government sets the reimbursement rates for the entire health care system, then doctors and hospitals who protest by refusing to accept Medicare patients (a now-common refrain) will find themselves without any patients at all.
Very well summarized and the anger is a nice touch. The GOP can't do health care because they don't believe in it or agree on what they want. So they should just leave it to the pros, which ain't them...
Something between and Ed Wood (maker of bad movies) movie and horror show that goes on and on, day and night. They want to do wrong and can't quite get it right.
A Strong Military AND a Healthy Population are what Preserve a CONSTITUTION AND a BILL of RIGHTS.
Without a Healthy Population, a Strong Military is of little or no value.
Without a Healthy Population, a Strong Military is of little or no value.
"...according to the latest Quinnipiac poll this bill has just a 17 percent approval rating. It’s no wonder that this bill is already massively more unpopular that Hillarycare and Obamacare"
Remember when the Republicans used to complain that Obamacare was "shoved down our throats". passed in the face of public opinion and with no bipartisan participation?
Remember when the Republicans used to complain that Obamacare was "shoved down our throats". passed in the face of public opinion and with no bipartisan participation?
Here it is, folks, not just the most insightful conservative commentary on the Trumpcare No-care bill, this is the best, most incisive and most frightening analysis, period.
Single payer looks more and more appealing every day.
As a response to the train wreck of trumpcare, perhaps moderate democrats and republicans could together craft legislation to make the Insurance exchanges of ACA sustainable.
The worst part of all of this is that the bill does not repeal the ACA. No matter how many different ways they amend this bill, it is a modification of ACA.Not a repeal at all.
I was struck by Brooks' statement, "I like health savings accounts, tax credits and competitive health care markets to drive costs down", but he goes on to say that reforms have to be fashioned for "the least amongst us". When did the Republicans last fashion and fight for public policy that affects millions of people for the "least amongst us"? I have seen no evidence of it in the current cast of characters who control the Senate and Congress, and certainly not Trump. Conservative principles like adoption of market forces for everything seem to always come at the expense of policies that would address the challenges of the "least amongst us". It makes one question whether or not the two can reasonably be married. Policies based on the dictates of market principles seem destined to benefit the wealthy and harm those who are not: "the least amongst us", but also those who have just enough income to do okay, but who would be devastated by a catastrophic health care event, which under this ridiculous bill could be something as basic as pregnancy.
The core vision for healthcare in the United States already exists in the form of the requirement that hospitals must treat everybody. Obamacare went in the direction of making that core requirement work more efficiently. The Ryan plan clearly goes in the other direction. The Trump plan has no content and both repeat the errors of the process and content of Obamacare.
What if we drained the swamp and had a bipartisan approach to healthcare? Since just about everyone needs healthcare at some point, it is absurd for it to be locked in this partisan debate.
What if we drained the swamp and had a bipartisan approach to healthcare? Since just about everyone needs healthcare at some point, it is absurd for it to be locked in this partisan debate.
So, you like "health savings accounts, tax credits and competitive health care markets". But why not single payer plan? I've had the good fortune of going through life needing no hospitalization and I don't need any prescriptions. But those less fortunate may need costly services that instantly drain their HSA's. We need a plan that equalizes the healthy and the sick, providing more assistance to those that need it, without ruining them financially. I suspect that the real problem with our system in the U.S. is that there are too many entities siphoning money out a system of nearly limitless health care dollars. This is why when compared to other countries we pay the most, while getting poorer results. Can you explain to us how your preferred method of "health savings accounts, tax credits and competitive health care markets" might hold down costs? Doesn't this just let the health insurers, pharmaceutical companies, et al, just keep on manipulating the system to maximize their profits?
Yes, and the bill will probably pass the house.
Any bill that is passed should be identical to the health care plan elected officials, appointed officials, all members of their families and staff get.
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Just like Trump, the Republican Party never produced a single politician passionately or even with any conviction that Americans had a basic fundamental right to health care.
Their philosophy has always been to ignore the social contract and never concede that government has an obligation to protect people from catastrophic financial loss due to a decline in health.
Lies about Obamacare are the norm and you are right, the swamp is just fine with the party and a large percentage of their base.
Their philosophy has always been to ignore the social contract and never concede that government has an obligation to protect people from catastrophic financial loss due to a decline in health.
Lies about Obamacare are the norm and you are right, the swamp is just fine with the party and a large percentage of their base.
The perverted elephant in the room, which no one seems willing to name much less face, is the real insurance policy this legislation ensures. In 2016, the Health Care industry spent a whopping 146.6 million on lobbying. The only insurance here is a policy that guarantees giant health insurance corporations pay out as little as possible in benefits, and reap as much profit-from-premiums as imaginable. It's one more example of vicious corporatism overwhelming democratic capitalism at the expense of the poor and sick.
First, I agree that we should end employer-provided health insurance. It distorts the market, and puts the employer between patient and doctor.
Second, we should clearly distinguish between health care, and health insurance. One of these provides a benefit, the other adds an unnecessary layer of cost and complexity and red tape and subversion of our democratic institutions.
The next logical step, single payer for all, supported by a small health tax or premium, call it what you will. We can debate the merits of a mandatory premium, or a tax on income or sales or business; I'm sure an equitable arrangement can be negotiated. (tongue slightly in cheek)
Second, we should clearly distinguish between health care, and health insurance. One of these provides a benefit, the other adds an unnecessary layer of cost and complexity and red tape and subversion of our democratic institutions.
The next logical step, single payer for all, supported by a small health tax or premium, call it what you will. We can debate the merits of a mandatory premium, or a tax on income or sales or business; I'm sure an equitable arrangement can be negotiated. (tongue slightly in cheek)
David, Re. your assertion that " I like health savings accounts, tax credits and competitive health care markets to drive down costs. But these free-market reforms..."
In the view of many scholars, healthcare is impervious to market forces; it's unique in that demand does not drive supply.
I'd be grateful if you could provide several real-life examples of developed countries in which your free-market concept of healthcare has born outstanding results in delivering inexpensive care and extending life.
In the view of many scholars, healthcare is impervious to market forces; it's unique in that demand does not drive supply.
I'd be grateful if you could provide several real-life examples of developed countries in which your free-market concept of healthcare has born outstanding results in delivering inexpensive care and extending life.
"I like health savings accounts, tax credits and competitive health care markets to drive down costs."
Now if we could reduce our health care debate to a contest between David's embrace of a regulated for profit system, and the many of us who support Medicare for all, with a congress that carefully studies the data on relative efficiency of the two models in the real world, we might begin to show that we can function as a modern nation.
Healthcare is an important aspect of our economy as well as our personal well being. Inefficient health care drives up costs across the board even making our exports less competitive.
I fear that if our political system remains a struggle between faith based belief systems, manipulated by the powers of corporate special interests, we will gradually be reduced to an inefficient, dysfunctional country of declining power and wealth.
Now if we could reduce our health care debate to a contest between David's embrace of a regulated for profit system, and the many of us who support Medicare for all, with a congress that carefully studies the data on relative efficiency of the two models in the real world, we might begin to show that we can function as a modern nation.
Healthcare is an important aspect of our economy as well as our personal well being. Inefficient health care drives up costs across the board even making our exports less competitive.
I fear that if our political system remains a struggle between faith based belief systems, manipulated by the powers of corporate special interests, we will gradually be reduced to an inefficient, dysfunctional country of declining power and wealth.
The eventual result is going to be what should've come first: single payer health care. Like Social Security and Medicare, it will pass when Democrats have a majority in Congress. As was the case with the latter two, conservatives will vehemently oppose such legislation tooth and nail. Then, twenty, thirty years from now, we will all be thankful that we have it.
"They could have drafted a bill that addressed the perverse fee-for-service incentives that drive up health costs, or a bill that began to phase out our silly employment-based system, or one that increased health security for the working and middle class."
Every one of these is a characteristic of the ACA - also known as Obamacare.
Really this entire article should have just been - why not fix the parts of the ACA that you Republicans broke in your intense desire to attack our last president?