Tag: healthcare

Categories
society

Superstition and Politics

One of the biggest problems with politics is superstition. Every time a candidate wins, their campaign strategists are treated as having conjured up a magical creature known as victory out of thin air. They are treated thusly by the party they won for, but also largely by the media. They pushed the right button combination, they cut the right wire, they made the thing happen. Never mind all the factors outside of their control, the flukes, the weather. They get credit without any definitive evidence that they even knew what they were doing.

But that’s not the whole of superstition in politics. It extends to all sorts of frets and worries that interrupt policy and legislation. The NRA has a monkey’s paw that will unleash torment upon Republicans if they don’t fall in line. Rich criminals like Weinstein and Epstein were insulated from accountability (again, in both the media and in political circles) by superstition, primarily. The worry about what it would mean to the unknown backwaters and backrooms of power to cross people who are the equivalent of made-men in those circles.

Superstition dictates that Republicans can’t compete in blue states, nor Democrats in red ones. They certainly shouldn’t treat those foreign lands as opportunities to throw some spaghetti at the wall on the cheap. I mean, it would be bad luck to run a Republican candidate in LA on the platform of (insert some idea that Republicans generally don’t run on but won’t be offensive).

The media similarly has its superstitions around politics, including what kind of coverage is expected, what polls really mean, which voters count more (evangelicals, soccer moms, NASCAR dads, etc.), who gets access, what the differences are between Republicans and Democrats, and so on. It has its superstitions about who is important and what ideas are important. Campaigns should be about identifying problems, but they’re mostly about offering canned solutions to undefined problems, and then the solutions become the focus and they aren’t perfect so candidates get tarred for that.

The problem of superstitions is quite extensive in our lives. They represent blockages that prevent honest progress, out of fear of the unknown. The media’s focus on the ten-year-cost of Medicare-for-All, despite the actual ongoing economic cost already being greater, is one example of this. The Republicans’ reluctance to give up on repealing the ACA, in favor of some real policy is another.

These superstitions exist because of mere coincidence. The apparent interest in Republicans around the time they championed repealing the ACA caused them to believe that people wanted repeal, rather than the people wanting further development of healthcare policy toward some unknown better system. The media believes then ten-year costs of Medicare-for-All are important because they believe big numbers are important.

I don’t think Medicare-for-All is the be-all-end-all of healthcare. It is one way to do the thing. But I do think that continuing to refine healthcare funding is entirely necessary, and systems that tend to diminish the involvement of employers in healthcare are generally superior to those that do not. Over a ten year period where healthcare isn’t provided by employers, ceteris paribus, we should expect a healthier economy and a healthier population.

Categories
society

Economic Infrastructure

There are several sectors that constitute economic infrastructure. Some are real infrastructure like roads, the electric grid, but others are not typically seen as infrastructure. The housing market, for example, is not typically seen as infrastructure, but it is part of the economic infrastructure—a necessity to building economic prosperity.

Other examples of economic infrastructure are healthcare, education, and media. In order to build economy, people need health, they need a knowledge base, and they need to filter new information through that knowledge base to keep it healthy and current.

The importance of economic infrastructure is two-fold. First, it provides the same support role that traditional infrastructure provides: it girds the other social and economic activities of a society. It allows commerce to operate efficiently and with routine expectations that fade into the background of life, letting those engaged in other activities focus on their local problems and challenges. Second, just like traditional infrastructure, it creates a base of economic activity to itself. This base activity furnishes a minimum and continuous economy that can cushion the dynamic economy that sits atop it. Even when downturns occur, children continue to go to school, medical practices continue to operate, and housing is still needed for all inhabitants.

Those that argue, for example, for Medicaid expansion in the states, are arguing for improvements to the economic infrastructure. As with traditional infrastructure, more developed societies should expect and require advanced economic infrastructure. A modern society could not function without a network of paved roads, nor should it attempt to function without schools, universal healthcare, and other robust forms of economic infrastructure.

Even the Internet, while built of physical infrastructure, also includes volumes of economic infrastructure in the forms of protocols and software, much of it open source, which allows for interoperability that supports massive economies.

In seeking to shore up traditional infrastructure, it is important to do the same with these institutional, economic structures that are as important to the modern economy.

Categories
society

Trends in GOP Policy (or the Lack Thereof)

On healthcare: work against it. Criticize any Democratic efforts to enact sane policy. On the environment: work against it. Criticize any Democratic efforts to enact sane policy. On taxes and IRS funding. On immigration. On trade. On housing. On transportation.

The Party of No is alive and unwell. And in power.

It’s hard to understand how folks support a policy vacuum. It wouldn’t be hard to understand if they simply had an alternative, but they have no policy on areas that matter to everyone.

Healthcare

Their work to-date has been to undermine the ACA (failed repeals ad nauseum, cutting advertising, cutting the enrollment period, cutting navigator funding, zeroing the individual mandate penalty), block Medicaid expansion, add work requirements, and expand scam insurance.

While they have put out policy papers in the past, outlining plans for market-driven healthcare, they’ve never made any real effort to enact them.

Take two doses of stupid policy, then elect Democrats when you realize the Republicans screwed it all up.

Environment

Their work to-date has been rolling back regulations that make the air and water cleaner. They want to undo the already-late update to vehicle fuel efficiency (and one is sure that they’ll not take increased traffic accidents into account when they approve oil leases and seek to keep gas prices low). They have no plans for enacting carbon taxes. They have no plans for what to do when the oceans rise, the aquifers dry up, the storms grow, the crops die.

Best I can tell, they don’t even bother with policy papers here.

Taxes

Cut, cut cut, cut cut cut, cut × 4, × 5, …

Their revenue policy is something out of a drug den. “Just need one more tax cut to clear my head, then I’ll actually accomplish something,” says the drooling, stupified Republican congressional caucus.

Again, no real policy papers. Just enough wishful thinking to fill a thousand fountains with pennies.

Immigration

Get rid of it. Under Trump, this apparently includes trade and tourism, too.

Some Republicans still support some types of immigration, but they don’t agree on which, and the end result is complete paralysis.

Once upon a time, there was a conservative party that shared policy goals with the country. They differed in the way to get there, but that was okay. We can all agree that we want pizza, but disagree on toppings.

Over time, they splintered until some in their caucus outright denied that eating was even necessary. They denied that pizza was a food.

At some point, the people are hungry. They’ll vote for Democrats that will serve them pizza with anchovies and pineapple and gummi bears if it means they get fed. The GOP really needs to stop simply criticizing every Democratic policy goal as impractical and too expensive. They need to get back to arguing about toppings.

Categories
society

The Importance of the Failure to Reform Healthcare

Mental health is an essential part of any changes to address gun violence, with suicides being a significant number of total gun deaths per year. But with the healthcare system still broken, it’s fanciful to suggest any real action on mental health in the United States.

Any major strike, such as the recent teachers’ strike in West Virginia, has healthcare as a sticking point. Replacing employer-provided healthcare, particularly in the public sector, removes a large amount of the friction contributing to labor disputes. It also removes the few, sticky religious freedom arguments that employers have about providing contraceptive coverage.

It removes a line-item that must be worried over year-to-year from most businesses and, depending on the implementation, potentially from most governments as well. That simplifies a lot of budgeting, freeing the workers responsible for maintenance of those decisions to shift to other tasks.

Drug prices, artificially high and an endless source of frustration for those with chronic ailments, can be brought in line, once again simplifying the economic decision making that saps energy from the populace. It can also simplify the work of the FDA and drug makers, who can better understand the targets for better drugs and better vetting of drugs.

On the issues of Medicaid, work requirements go away along with the incentives to impose them (budgetary pressure). Doctors can focus on patient health, and patients can focus on employment, all without these external, artificial pressures.

All of it can be done in a way that saves money by shifting private payments to public payments and raising taxes to offset the public costs.

The failure to honestly approach healthcare reform impacts gun violence, labor disputes, the unreasonable costs of healthcare, has a negative effect on business productivity, and forces states to treat the poor like liabilities rather than human beings.

Fixing healthcare will help treat a number of societal problems, if only there were the will to do it.

Categories
society

On Taxes, Republicans Bet Against America

The Republican tax plans come together with a theme, which is a unifying feature that is found throughout. In this case, that theme is that America is a loser.

We see it in their continued indifference to maintaining a modern healthcare system with universal coverage. They plan to repeal the individual mandate without replacing it. They bet that either:

  • The mandate is ineffective, in which case the deficit rises by hundreds of billions more.
  • The mandate is effective, in which case millions will be without coverage.

In either case, healthcare costs will continue to worsen due to this bet, and there will be no benefit to the country.

We see it in their treatment of deductions and carve-outs. They leave subsidies for oil and gas and coal. They remove others, like deductions for medical care, school supplies. They bet that teachers and the infirm will suck it up. That teachers are not the backbone of the nation. That sick lives don’t matter.

They bet on debt, claiming that the cuts will result in unprecedented growth. They bet that all of the cuts in spending that will be required under paygo will either not occur, or won’t result in reduced economic activity. They bet on increased investment by businesses that themselves say they won’t increase investment very much.

And then they bet that the overall economy is not due for another recession. A recession that would be more harmed by the lack of opportunity to cut taxes further among other anti-recession treatments that would be needed.

In short, the Republican tax plans continue their march against knowledge, defying physics and reason. They even bet against their own reelection, as when the mess of this risky nonsense unfolds, there’s no way that folks are going to send a majority of the designers of misery back to DC.

The kicker to all of this is that all these cuts will be reversed in the aftermath.

Everybody expected the Republicans to cut taxes as part of tax reform. Nobody expected them to be fully-responsible stewards of our government, as we all know that’s not who they are. But once again they show themselves to be far worse than our expectations, as they did with healthcare.

Instead of pushing for a conservative bill, they push for a monstrosity. Instead of doing away with almost all subsidies, deductions, and credits, which would be the conservative move, they have chosen to write bills that are extremely lopsided.

We need real conservatives that actually hold to their notions, to balance with the progressive impulses of their counterparts, but we get faux conservatives that care not for governing responsibly. They will raise the deficit and debt. They will not create balanced legislation. They are snot-nosed brats that should be sent to time-out come 2018, come 2020, and until they are willing to govern with the integrity the legislature demands.