HEALTHCARE IS A LAND OF CONTRASTS

In teaching one gets used to the fact that no matter how many different ways it is strategized around or how many reminders are given, students are going to do their written work at the last minute. Divide the assignment into sections, give pep talks, urge them to get started before it is Too Late…none of it will matter in the end. Most students will be writing the paper the night before it is due. And very few of them are naturally smart and gifted enough to slap something together on a 5 AM Monster Energy and Ritalin bender that is actually good. They think they can, of course. But here's the thing: they can't.

I've used the analogy a number of times that Trump's unscripted statements sound exactly like an oral presentation given by a college student who forgot that he had to do an oral presentation in class today. The bravado, the confidence in his own bullshitting skills, the superficial knowledge (often consisting of facts that are not actually Facts), the generic and empty language, and the failure to hide disdain for the idea that you people dare judge someone as great as him are well recognized by anyone who has taught before.

Over time, though, two things are becoming clearer. One, this problem is not limited to Trump. The Republican Party that once touted itself as the "Party of Ideas" is officially at a point where it has no ideas whatsoever. Not bad ideas, which is a different issue, but no ideas. They are now designed solely for obstruction and have no ability to govern now that the dominant ethos has gone from "Let's govern this way instead of that way" to "lol governing sux." Should we be surprised that a group of people who claim that the free market can solve any problem in a complex society struggle to come up with concrete proposals for governing? No. But that doesn't make it any less shocking that after seven full years of trying to repeal the ACA, House Republicans had to slap together a half-assed proposal the night before the due date because they had nothing prepared. Not "We had a plan ready but some parts are works in progress" unprepared. Literally unprepared. They had nothing. And regardless of the amount of time – seven years might as well have been seven days or seventy years – that is what they would have had: nothing. They no longer bother with the pedantic and time consuming tasks of coming up with "ideas" or "solutions." This is a party designed to obstruct and nothing more. Hell, some of them were heartbroken Trump won, having become a machine well designed to prevent a Hillary Clinton from doing anything. Working with a president? That, they haven't a clue how to do.

The other thing I realize with time is that the same student who slaps a paper together at the last second is unlikely to produce a paper much better by starting the assignment earlier. The person who cares so little about what he or she writes that the assignment is left until hours before the deadline is not the kind who will devote greater attention to it just because more time is available. In other words, if you're gonna half-ass the paper at the last minute you will probably half-ass it whenever you do it. The problem isn't the time you have available; the underlying problem is that you half-ass things.

This applies to the Republican analogy as well. No matter how much time they do or don't spend trying to create policy, they're such a one trick pony now (Cut taxes + magic = Everything's Super) that they wouldn't have produced a markedly better ACA alternative had Paul Ryan spent seven straight years working on it. The means is the end for Republicans; they propose cutting taxes for the wealthy as a means to solve any and all problems because – ta da! – all they really care about doing is cutting taxes for the wealthy. Does it "work"? Who cares. As long as it gets done on a regular basis it doesn't have to work. Their job is already done.

Democrats lose elections because they propose things that voters don't like or that strike people as unnecessarily convoluted. Republicans avoid that problem by being for nothing and against almost everything. You have to hand it to them, it's a brilliant system. The flaws become apparent when the GOP, like a dog that finally catches a car, ends up with control of all of our political institutions.

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45 Responses to “HEALTHCARE IS A LAND OF CONTRASTS”

  1. Mark Says:

    Substitute "Democrat" for every "Republican" in this piece and one has written an actual true column.

  2. Nunya Says:

    Wow, Mark. Way to blind us with your political acumen and nuanced thought. Im sure you can serve under Betsy DeVos with an intellect like that.

  3. Mysteries Of Life Says:

    Mark if you are going to troll this site you should come up with a better alias or moniker. I'm sure you can come up with something before dinner while living in your parent's basement.

  4. Spacegeek Says:

    Mark: Wait, so Democrats have been trying to repeal the ACA for seven years, and their solution to everything is to cut taxes? Your substitution really doesn't make any sense at all.

    But I'm sure you thought you were very clever.

  5. SeaTea Says:

    It's cute. I know a guy like Mark, except on the left. He just goes around every day dropping provocative bombs on every thread he can find and walks away thinking that he's done something clever. That it's some kind of positive accomplishment to poke a hornet's nest then walk away. Now that I've seen it in action, I just find it cute. If you knew Mark in real life, you'd see him doing the exact same thing in 40 places all over the Internet every day. It's his substitute for an actual raison d'être.

  6. Ormond Otvos Says:

    The ACA, compared to the rational single payer, is garbage. It's better than nothing, but seriously flawed.

    Ryancare is not worth thinking about. Yes, I read it.

  7. Miller Says:

    And the sad thing is, when your only real goal is breaking government, this strategy still kinda works.

  8. Net Denizen Says:

    Everyone leave Mark alone. He's just playing the "Both-sides-ism" card!

  9. Major Kong Says:

    Shorter Mark: "I know you are but what am I?"

    Always a pleasure to meet someone who appreciates the classics.

  10. Mothra Says:

    You apforgot that Republicans have no desire to produce useful legislation because then people might actually like government.

  11. Well. Mostly Says:

    The term paper-oral presentation analogy works well. Half-assed is all there is.
    A fancy cover, a tight index, and observing all the outline rules doesn't help if there's no real thought put into it.
    Sorry for the sports thing here: the so-called freedom caucus rushes the passer on every play no matter. The line-men stand their ground and watch the play go around them, and the heroic backfielders seek brilliant, tactical pass deflections even on a running play. Give them the ball and they don't know what to do with it. They turn it into a rugby scrum.
    Sadly, the dems spend too much time at the chalkboard devising complicated plays that only a few players understand.
    It's a recipe for how things are. Yikes.

  12. April Says:

    @MK – Bravo! THAT was worth getting up at 4AM for. THANKS.

  13. DrBDH Says:

    My representative, Sean "The Lumberjack" Duffy isn't smart enough to sound like he's faking an oral presentation. He sounds more like the kid explaining to his mom why he had to skip school to watch the matinee of Matrix 3 (you know, the one that sucked the most).

  14. negative 1 Says:

    Not only is this point true, it's why any republican like Ryan who actually proposes an idea, no matter how poorly designed, cruel or obviously flawed is immediately a 'wonk' or a 'policy genius' while a democrat who proposed anything for fixing insanely rising student debt or income inequality had to be have the whole thing tax-neutral and projected for 20 years from the word 'go' or be thought of as 'unserious'.

  15. democommie Says:

    "students are going to do their written work at the last minute.".

    I often failed to do it at all. I also had no math ability and actually slept, a lot, during classes. I also had what was diagnosed, twice (age 44 and 54–different psych evals) as pretty severe ADD/ADHD; a little too late to do me much good while in HS. Eventually I graduated with my class (and I think the lowest GPA .88 that they ever sent out into the wide world) and somehow made it this far. I actually think that my teachers and the school administrators knew 2 things. First, that I was pretty smart, albeit completely scatterbrained. Second, that they were fed-up with trying to figure out what was going on and it was easier to send me away.

    Trumpligula may well have severe learning disabilities. That he's been enabled, apparently for most of his life, in his bullying and lying cannot but help to make him the p.o.s. he is today.

    As has been said here and elsewhere; the Giant Orange Pouter's party has one aim in the healthcare area. Fucking as many people as possible, as hard as possible and as fast as possible. That's it.

    Mark:

    Back away from the TomCat bait station, that shit isn't laced with warfarin, anymore. It's bromothalin and instead of causing internal bleeding it causes brain swelling and worse. Go back to the Cheetos and Dew, boring but safer.

  16. Redleg Says:

    Ed- nice post. The GOP thinks it should get brownie points for having a much smaller healthcare bill than the ACA.

    The only thing rehearsed about Paul Ryan's presentations is his fucking smirk. Everything else is just bullshit about freedom, choice, markets, etc. that he learned from the prominent economist Ayn Rand.

  17. Grendel Says:

    The Paul Ryan proposal managed to both cover less people AND cost more money while only really accomplishing a small tax cut for the wealthy. It's a thing of beauty, by Republican legislative standards.

  18. RosiesDad Says:

    How do you know that Paul Ryan hasn't been working on this for seven years? He is, after all, the intellectual leader of the GOP.

    Brilliant post, Ed. I will share this widely.

  19. Gerald McGrew Says:

    As soon as it was announced that Trump had won and the GOP kept control of both houses of Congress, my first thought was, "Well, this isn't going to be good for right-wing radio and Fox News".

    The reason is what you touched on Ed….they're fantastic in attack mode. When all they have to do is armchair quarterback and throw rocks at the adults who are trying to actually do things, they're in their element. But as soon as it becomes "Ok, now YOU'RE the adults in the room and have to run things", they have to start making decisions and defending them. And as we've seen, they totally suck at it.

    Just look at the current discourse. Since the Republicans control the WH and Congress, they really don't have a foil they can blame everything on. So what do they do when faced with something bad one of their own has done, like say……..conspiring with Russians? They blame and attack the only person they can think of….Obama.

    I bet they felt so relieved when Levin gave them that chew toy.

  20. Tim H. Says:

    Something to look at:
    https://www.kickstarter.com/projects/560181280/trump-troll-doll-sculpture-by-chuck-williams
    But possibly not too close to meal time…

  21. mago Says:

    All so high school. Although MK nailed it with the school yard taunt.

    Too bad the stakes are so high.

  22. Big Tim Says:

    I just love this blog and the crowd

  23. c u n d gulag Says:

    All of this, while t-RUMPLE-Thin-Skin wants to increase our military spending dramatically – I imagine it's to protect us.

    Why bother?

    In about a year or two – probably a lot less time – between Orange Russki Pussy 'n Toot's' and the GOP' Congress's complete destruction and dismantling of America, NO COUNTRY IN THE WORLD WOULD THINK OF INVADING US!!!

    Which country would want to feed, house, and care for the millions and millions of non-rich American refugees and displaced persons, who – when all of the conservative poo-poo finally met the oscillating blades of reality, and everything fell apart – couldn't escape with their families to a mansion (or two… or three.. or four… or…) in another country (or two… or three… or four… or…)?

    Shit, even North Korea's leader isn't that fucking stupid or crazy!

    Hell, we won't want to try to survive an invasion:
    By that point, we'll probably all be hoping some country nukes us, and puts us out of our fucking misery.

  24. Grendel Says:

    @CUNDG At the same time we're increasing the military budget and building a big wall we're gonna cut the Coast Guard and port inspection budgets… So essentially we'll go overseas to piss people off while not checking our ports of entry for terrorist threats, but at least we'll have a big wall keeping all the Messicans out who didn't want to come here anymore anyway.

  25. wetcasements Says:

    Seven years. And lest we forget, there's no shortage of Granny Starvers over at Cato or AEI who must have put together over a hundred white papers on how to do this since the ACA went through.

    And they still fucked it up.

    Republicans still scare the living shit out of me due to their callous and evil natures, but I'm a lot less worried about their actual competence.

  26. jharp Says:

    "Trump's unscripted statements sound exactly like an oral presentation given by a college student who forgot that he had to do an oral presentation in class today. The bravado, the confidence in his own bullshitting skills, the superficial knowledge (often consisting of facts that are not actually Facts), the generic and empty language, and the failure to hide disdain for the idea that you people dare judge someone as great as him are well recognized by anyone who has taught before."

    Ive never taught before and I recognized this nearly perfect description of the asshole roughly 15 years ago.

  27. define and redefine Says:

    Even Cato isn't on board with this shit –

    https://www.cato.org/publications/commentary/congressional-republicans-obamacare-replacement-wont-cut-it

  28. Talisker Says:

    Calvin & Hobbes got there first.

    Calvin has to give a report on bats, which consists of one "fact" he made up, and he expects an A for using a professional-looking clear plastic binder: http://www.gocomics.com/calvinandhobbes/1989/10/31

    Paul Ryan is an adult Calvin without the imagination. He expects us to be awed because he has a plan containing actual words on pieces of paper, presented in a clear plastic binder.

  29. democommie Says:

    "ve never taught before and I recognized this nearly perfect description of the asshole roughly 15 years ago."

    I got that Trumpligula was a sneering , overweening fuckbag the first time I ever saw/heard him. That was well over 30 years ago. It took a while longer to find out that he was a liar, cheat, bullshitter, coward, truth-stretcher, bully, dissembler, spendthrift, prevaricator, inept businessman, snake oil salesman, codswallop merchant and all around fuckbag. Did I mention that he's menacious?

    His staff and the Trumpliguturds say that he's misunderstood by all of us and misquoted by the various persons who report on him. If there weren't literally THOUSANDS of hours of video tape with him smugly, boastfully, deliberately and STUPIDLY saying the shit that he sayss, well, y'know…

  30. geoff Says:

    Part of the problem of course is that the ACA was a Republican plan to begin with! It was already loaded down with "market based/ consumer choice" claptrap that helped doom it from the get go. Turns out insurers don't want to compete; they just want to take your (or Uncle Sam's) money for premiums and deny you coverage for actual medical care.

    What I find amusing is that so many Congressmen and women are JUST NOW waking up to the fact that flawed as it is, the ACA has helped a lot of people (full disclosure– like me), and it's not quite as politically unpopular as they thought once it's actually on the chopping block.

  31. Bob Says:

  32. Paul Says:

    @Bob

    You have won the argument.

  33. doug Says:

    'Democrats lose elections because they propose things that voters don't like or that strike people as unnecessarily convoluted.'

    D's lose elections because they have fucked common people and hang out with the exact same money folks as the R's. See income disparity grow and grow over the Oman years without comments/actions from D's to ameliorate for example.

    Otherwise brilliant essay…

  34. This Guy Again Says:

    When I was growing up, my father always used to tell me that the Republicans are the party of bad ideas and the Democrats are the party of no ideas.

    Ed seems to be telling us the roles have changed.

  35. GunstarGreen Says:

    @geoff RE: The ACA's popularity.

    It turns out that the ACA is actually quite popular even with the Republican voting base — they just didn't realize (intentional, due to Republican misinformation campaigns) that the ACA that they rely on and the Obamacare that they hate are the same thing.

    There's a reason Republicans worked so hard to brand it as Obamacare. The Obama is the important part. It's a brainless shortcut to "hate this because Obama", all facts be damned.

    It is for reasons like this that I'm not as broken up about Trump being elected as some people. Yeah, it's going to suck for at least four years. It's going to suck *hard*. But some of that suck may serve the purpose of waking some folks up to the cold, hard realities of what the political parties actually stand for.

  36. Gerald McGrew Says:

    To tag on to the "why Democrats lose elections" thread, the recent Los Angeles Mayoral election serves to illustrate the point I've been making on this for some time now…….the Democratic base is too reliant on low-turnout groups (blacks, Latinos, youth).

    In the LA election, there was a turnout of 11%. Yes, you read that correctly…..11%! In a year of supposed Democratic voter energization, in a city that just 2 months ago had large anti-Trump rallies, only 11% of the electorate bothered to show up to vote.

    THAT'S why Democrats lose elections.

    https://mic.com/articles/170604/la-county-voter-turnout-was-11-45-on-tuesday-that-won-t-cut-it-in-trump-s-america#.LPX4F4dEW

  37. geoff Says:

    @GunstarGreen, sure, GOP voters' hate for "Obamacare" is largely based on hatred of Obama, who, hey, isn't around anymore. It's like the Tea Partyers' "Keep Your Government Hands Off My Medicare" thing, hilarious and nonsensical.

    (And while I DO benefit from the ACA, I'm more of a Medicare For All guy. Why are we giving 10%+ of our healthcare dollars to predatory for-profit insurers? It's ludicrous!)

  38. Katydid Says:

    @Talisker: Bats aren't bugs!

  39. Bitter Scribe Says:

    In explaining his "plan," Paul Ryan was very indignant that under Obamacare, sick people would benefit from the payments made by healthy people.

    He obviously has no idea how insurance works.

    I've paid for car insurance steadily despite not having had an accident in more than 15 years. Should I be indignant that my payments "subsidize" drivers who get into accidents?

    No, because I could get into an accident myself one day. Then the payments made by others who didn't would "subsidize" me. That's the whole goddamned idea behind insurance.

    Remind me how this guy got a reputation as a "policy wonk"?

  40. democommie Says:

    "'Democrats lose elections because they propose things that voters don't like or that strike people as unnecessarily convoluted.'"

    Democrats lose elections for two reasons.

    First, they aren't as good at lying, cheating and stealing as the GOP.

    Second, anything beyond, "I'm going to fuck other people and pass the savings on to you." is lost on a large number of voters.

  41. Brian M Says:

    demo: You must not be a resident of a one party Democratic Party state. c.f. California, New York, Illinois (specifically Chicago). Plenty of cheating and stealing (and pandering…just like the Republicans).

    Note I am not commenting on political platforms…Hezbollah (God's Own Party) takes the cake for vicious theocratic platforming and policy.

  42. democommie Says:

    @ Brian M.:

    I live in Oswego, NY, I used to live in MA & NH (I spent about thirty three years, jumping back and forth as job, commitments and romance dictated). I grew up in Omaha, NE. Omaha was reaonably liberal/reasonably conservative until about 1976–in my experience. The rest of the state was republican controlled–people who hated welfare and loved farm programs and cheap leases on BLM grazing tracts. That seems to have changed, for the worse. The state is batshit with Omaha leaning batshit.

    Oswego is a "liberal" college town of approximately 18K (+ ca. 8K college students, in season). There are lots of good union (or union equivalent for pay/benefits) jobs at 3 nukes, a huge aluminum plant and the regions largest hospital. The school budget runs to $70+M.

    Having said all of the above about Oswego, it's odd that it's got a reptilican mayor, a reptilican city council and a "local" paper that is Pravda Liteski. Our county lege is overwhelmingly controlled by the GOP. If you want a job working for the county, you really need to register "R" so that your application won't find its way into the circular file. The new mayor canned somebody in his office and said it was because the person contributed to his opponent's campaign–and it didn't seem to generate a lot of controversey. My city councilman switched parties before the last election, but too late for anyone to file to run against him–so he could get a job with the county. I will never speak to that motherfucking traitor again.

    So, now, not living in a "1 party" state.

    The NYS Assembly has an overwhelming democratic majority, but they are not lockstep capable, never mind inclined. The difference being, I think that democrats, particulary teh gay, notwhite, hajib wearing, etc., aren't just like that on the outside v people like Ben Carson, Bobby Jindal, Ben Nighthorse Campbell and the like.

    The NYS Senate is GOP controlled and has been for decades with a few exceptions. Dating back to 1965, the Senate President has been a "R" for all but about 2 years out of the last 51. In order for a Senate member to be elected President they must, obviously control the requisite number of votes. So, either, the Republicans are dearly loved by their Democratic opposites (pinocchio moment, excuse me) or they are in effective control.

    NYS with all of its faults and there are a LOT of them is a far better place to live if you have need for social services and the median income here, with all of the poverty, corruption and welfare was ranked fifth of fifty states for per capita income.

    I used to think that Republicans were the heartless ones and Democrats were the corrupt ones. What I see now is that Democrats are corrupt, Republicans are corrupt, but the Democrats STILL don't just write off about 80% of the populace as "useless eaters".

    Republicans are about not spending money, except in the form of development grants and low-cost loans for bid'neth; funding the shit out of LE, not so much for FD, education or social safety nets.

    I'll take the moral, fiscal, commie swamp of the Northeastern U.S. over the tax paradise states of the former CSA, AZ and other KKKonservaturd resorts.

    * https://www.northcountrypublicradio.org/news/story/33022/20161202/democrats-hold-majority-of-seats-but-don-apos-t-yet-control-ny-senate

  43. Katydid Says:

    @Democommie; here's something I've always wondered; why is Vermont so liberal and New Hampshire so *not*? They're both tiny states, bordering each other?

  44. democommie Says:

    Vermont is, imo, more libertarian than liberal. The southern end, up through ski country, is pretty well larded with New Yorkers and other folks who spend their downtime in vacation settings. When you get up above Champlain, they seem to be much more conservative, but in the true sense of the word. They don't really want to have people tell them how they should live–and they seem to reciprocate.

    One of the VP's at Verizon, Boston said to the gathering I was in a while back that she and her husband were surprised to see so few AMERICAN FLAGS waving in Vermont when they had been there a few weeks previously (the meeting took place in mid 2003, if memory serves). She wondered if they were insufficiently patriotic up there in Maplesugartopia. I liked her and she was waaaaaaaaay further up the food chain than I was, but I mentioned to a third level manager I got along with that she might want to check her facts on that comment. Vermonters never impressed me much as flag wavers (and flag wavers impress me not at all) but they seem willing to carry them into battle at a rate that is disproportionate to their population.

    I think that in 2007 they led the nation in the unenviable statistic of having the highest number @ 61/1M of combat deaths in the Iraghanistan Nation Leveling Project*.

    NH was very conservative until it started to fill up with Massacommunists from the northern fringes of that GODLESS state. These days it's sort of almost liberal south of Concord and HardcoreRightlite, north of there–in my experience.

    * Reducing infrastructure and economies in countries that piss us off to the level of neolithic societies.

  45. Katydid Says:

    Thanks, Demo.

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