Ethics Alarms feels obligated to state what should be obvious, but increasingly is not, as abuse is heaped on the Republican House and President Trump for failing to be able, for now at least, to agree on a replacement/repeal/fix for the Affordable Care Act, “Obamacare” its close friends….enemies too, come to think of it.
The headlines on stories all over the web describe the lack of a GOP bill are brutal:The failure of the Republican health care bill reveals a party unready to govern (Vox)…Republicans Land a Punch on Health Care, to Their Own Face (New York Times)…Inside the GOP’s Health Care Debacle (Politico). Those are the nicest ones. The conservative media’s headlines are even more contemptuous. This only reflects how much the prevailing delusion on the Left and by extension the Left’s lapdog media and punditry, has infected political common sense, leaving a Bizarro World* sensibility about what ethical governing is about.
It may be futile to point this out from this obscure corner of the web, but hell, I’m a fan of quixotic endeavors: the House health care bill was a bad bill. Virtually everyone who examined it thought so. If the thing had somehow been passed by the Senate (it wouldn’t have been, so this meltdown just got all the abuse and gloating out of the way early) and signed by the President (who admits that he has no idea what a “good” health care system would be), it would have thrown millions of lives and the economy into chaos. It isn’t responsible governance to pass bad laws. (Why is it necessary to even say this?) It’s irresponsible. The Republicans wouldn’t show they were “ready to govern” by passing an anti-Obamacare bill that made a bad mess messier; they would have shown that they were fools, reckless and incompetent.
You know: like the Democrats when they passed the Affordable Care Act.
So eager were the Democrats and President Obama to pass a law that gave health insurance to the small percentage of the nation that couldn’t get it (or didn’t want to pay for it) that they rushed through a sloppy, ill-thought out law without even reading it. The President didn’t read it (unless you believe he was deliberately lying about that “keeping your plan if you like your plan stuff”—I think he was lying by representing that he was certain of a bill he hadn’t read, which is a teeny bit better…I guess…), because “details, details”: he wanted a law passed. Legacy, you know. As his Speaker of the House said, we could find out what’s in it after it is a law. That’s being “ready to govern”? Blindly passing a law affecting every American, millions of companies, and billions and billions of dollars on a wing and a prayer?
Apparently so in the new, Bizarro World thinking of U.S. Politics. “Do something!” is the refrain we have been hearing from Democrats for eight years–on gun control, on racism, on climate change, on campus assault, on immigration, on the Iranian nuclear threat. Never mind if …
…the “something” is unconstitutional, like the Democratic plan to take away the Second Amendment and Due Process rights of Americans on no-fly lists. Never mind if
…the “something” is cultural airbrushing and government censorship, like banning depictions of the Confederate flag at national Civil War Battle Fields on the crackpot theory that the emblem encourages racial hate. Never mind if
…the “something” is killing the Keystone pipeline to send a “message” about our concern for climate change, while admitting that the project would have had no climate change impact at all. Never mind if
….the “something” means destroying the academic careers and reputations of male students not permitted to defend themselves in campus kangaroo courts that begin with the presumption that any woman’s claim of rape must be true. Never mind if
…the “something” means that the United States will hold out the promise of citizenship for the children of illegal immigrants, if their parents can somehow smuggle them into the country.
…the “something” provides a sponsor of world terrorism with billions of dollars to pursue that end, while doing nothing to ensure that a consistently perfidious Iran won’t eventually have the capablity to reduce Israel to radioactive rubble.
These and more were also bad provisions, bad policies, bad proposals, bad treaties or bad laws, all somehow proclaimed by Obama, Democrats and progressives to be virtuous, valid and praiseworthy because they meant being proactive, even though they made the problems they were designed to address worse—in some instances much worse.
Obamacare was another such “something,” arguably the most reckless of all.
Now the Republicans are being mocked for not adopting this irresponsible pattern: charging ahead with enterprises even after it is clear, or should be, that the results are likely to be catastrophic. In the Times today are several rueful quotes from Republicans about “letting the perfect be the enemy of the good,” an occasionally useful maxim that in politics more often functions as a rationalization for “Do something!” It would have taken integrity and courage for Democrats to look at the Affordable Care Act in 2009 (of course, this would have required reading it) and say: “You know, this is too complicated, too expensive, too unstable and too uncertain to pass. Too bad. Better go back to the drawing board. Involve the other party. Do it right. This is too important to screw up.” They couldn’t muster it.
In passing the ACA, the Democrats reenacted the scenario inveighed against by historian Barbara Tuchman, in many of her works, but specifically in her justly famous “The March of Folly.” The book explains how over and over again, otherwise smart and competent leaders pursue courses of action long after it is undeniable that the like results will be disaster. The first time I referenced the book, ironically enough, was in regard to Obamacare:
“The March of Folly” was a cold-eyed retrospective of how supposedly brilliant people in power can follow through on destructive and objectively stupid policies; how a mission, ordered by a trusted leader, travels the arc from aspiration to compulsion to obsession, and how the public, paralyzed by deference to authority, inertia and restraint, accepts flawed premises long after the damage they are doing and will continue to do are obvious and undeniable. Tuchman calls this lethal tendency of policymakers a “process of self-hypnosis.” She concentrates on its long and bloody history using examples spanning the Trojan War, through the British handling of the American rebellion and the Vietnam War. In another publication, she applied similar analysis to the infamous Charge of the Light Brigade. This is what is going on with the Affordable Care Act, and I doubt whether anyone with the necessary influence will stop it until it becomes a chapter in another historian’s sequel to Tuchman’s classic.
We simply have to banish this insane—no, that is not too strong a word—preference for badly planned and executed action with good intentions over responsible inaction in the absence of a competent plan. No, the Republicans and the President don’t deserve extravagant praise for talking as if replacing Obamacare was the easiest thing in the world, and they had the answers: that was irresponsible, dishonest and ridiculous. But at least they didn’t take the next step—the step the Left loves so much—of taking action when they had good reasons to believe that it wouldn’t work. Not passing bad laws just to “do something” is more responsible than passing them. Stopping a planned course that you have promised and hyped is more ethical and courageous than going through with it. Doing something just to do something is not competent leadership. It is leadership malpractice.
*Bizarro World is a planet in Superman Comics where the stupid populace has everything backwards: they say hello when they mean goodbye, good is bad, bad is good, and they eat the polates while throwing out the food on them. The term is used on Ethics Alarms to describe toxic cultures and irrational ideologies.
The failure of the Republican health care bill reveals a party unready to govern (Vox) This is just another headline in a long line of accusatory propaganda headlines and smears presented to undermine Trump and Republicans, these things shows a complete disregard for the truth. The political left is having a really hard time seeing the forest for the trees.
Which leads me to some interesting things I read on Friday.
American democracy: Not so decadent after all by Charles Krauthammer
(I think it was a bad choice to use the word “decadent” in the title, a better word to reflect the opinion contents would be “dysfunctional”. )
A couple of things Charles Krauthammer said in his column on Friday; “The last two months have brought a pleasant surprise: Turns out the much feared, much predicted withering of our democratic institutions has been grossly exaggerated. The system lives.”,
“Two months into the Trumpian era, we have our answer. Our checks and balances have turned out to be quite vibrant.”,
“1. The courts. Trump rolls out not one but two immigration bans, and is stopped dead in his tracks by the courts.”
“2. The States. Federalism lives.”
“3. Congress. The Republican-controlled Congress (House and Senate) is putting up epic resistance to a Republican administration’s health-care reform. True, that’s because of ideological and tactical disagreements rather than any particular desire to hem in Trump. But it does demonstrate that Congress is no rubber stamp.”
“4. The media. Trump is right. It is the opposition party. Indeed, furiously so, often indulging in appalling overkill. It’s sometimes embarrassing to read the front pages of the major newspapers, festooned as they are with anti-Trump editorializing masquerading as news. ….better this than a press acquiescing on bended knee, where it spent most of the Obama years…”
“…it is deeply encouraging that the sinews of institutional resistance to a potentially threatening executive remain quite resilient.”
“Two months into the Trumpian era, we have our answer. Our checks and balances have turned out to be quite vibrant.”
These things that Krauthammer talked about are encouraging and the political left is ignoring these points in an effort to smear instead of seeing the reality that’s staring them in the face. The political left refuses to see the forest for the trees, they are blind to the big picture. I’ve stated a number of times that Trump has opposition in his own party and that he would not get a rubber stamp from the Republican majority in Congress; this failure of a Republican health care bill to get rid of Obamacare is proof of the checks and balances build into our system of government and it’s time for the political left to get their head out of their ass and either start working with Republicans or make themselves irrelevant.
What are brilliant and vibrant checks and balances this season were mind-numbingly foolish and works-gumming obstructionism last season.
What I think is the better indication of health is that a party in power is opposing itself. You think democrats will ever behave that way?
The Republicans had plenty of time to sort out priorities and come up with an acceptable bill. They didn’t but apparently there were enough non lunkheads in the Republican side of Congress to stop this monster from rolling through. I give them some credit for that however something will eventually be done as Obamacare fiscally goes down the toilet. Let’s hope that they’re up to it.
No Democrat ever spoke out against the use of the IRS to target the Tea Party.
No Democrat is speaking out against the illegal unmasking of American identities in raw intelligence intercepts.
Should they manage to defeat Trump in 2020, our democracy is dead as a doornail.
“sloppy, ill-thought out law”
Or was it carefully thought out to produce maximum chaos? Diabolical seems to me to be as possible as sloppy.
Could it be both?
On Friday’s ‘Morning Joe’ host Joe Scarborough quotes the late Senator Paul Simon who said that in politics: “sometimes when you win, you lose. And sometimes when you lose, you win.”
What’s the hurry? Obamacare is a huge piece of legislation and regulations. Who cares if it takes a year or two to come up with a better program? Maybe people in Congress will read what they’re voting for or against. Maybe the Republican leadership will let Congress read the bill before they call for a vote on it. What a concept.
Basically, I agree with your fundamental point: haste makes for serious waste.
I do, however, quibble with your comparisons with Obamacare (I wish someone would write a history of it).
Obamacare was passed as a compromise, doling out in traditional politicians-at-the-table manner a bit for the insurance industry, a bit for hospitals, etc. But at ROOT it was conceptually clear: the government was going to mandate, and heavily fund, health care. Everything else was gloss. It was clearly a step in one direction, a left-learning, socialist if you must, direction (like all the rest of the developed world, who gets more effective healthcare for less cost).
By contrast, the GOP plan – which lets not forget they had 7 years of bitching and moaning to create – was FUNDAMENTALLY self-contradictory, at odds with itself. It simultaneously promised to cut prices, cut costs, and improve healthcare. Aimed at Trump supporters, it fundamentally disadvantaged them. It was pitched as less government, while at the same time promising continued and even increased benefits.
That is just lying, crazy-ass, self-contradictory BS. In no way can it be compared to Obamacare – which whether you agree with it or not, was basically a single-concept plan – get the government more involved in a universal-coverage approach to healthcare.
You don’t have to agree with Obamacare – but don’t pretend for a minute that the insane pandering self-contradictory program that just got blown out of the water came anywhere near it in coherence.
I’m not comparing anything but the fact that both are negligent, dishonest, bad bills that don’t do what their supporters promised. The one that got passed is obviously the worst: by definition. I have no problem with a GOP bill adversely affecting GOP voters—see, Charles, the idea is to do what’s best for the nation, not to partition the public into competing tribes—the Obama approach.
I have no problem with any law that works and is fiscally responsible, and is passed without lying. But Obamacare qualifies on no counts. It swore the mandate wasn’t a tax, then argued that it was. Obama’s lie we’ve covered. It was, many believe, designed to fail. It was amended illegally by edict rather than by Congress. It has mad deductibles and premiums unaffordable for people who once could afford them, making its very name a lie.
Stooping to defending this miserable cheat by stooping to Rationalization #22 is beneath you. Yes, the GOP bill was worse, and they had teh sense to reject it.
And since I have vowed never to let anyone get away with the ridiculous “the rest of the world does it, so we should too!” That’s just everybody does it, a naked and vile rationalization. If the US had followed that logic, it wouldn’t exist. I get it: progressives wish they lived in Europe. The fact that they think this way undermines their credibility.
The GOP plan, I should have added, can only be coherently described as a tax give-away program for the rich, funded by lowered benefits to the poor. THAT much was actually quite clear.
That’s what the talking points say, Charles. Frankly, I have no idea. I haven’t really familiarized myself with the Ryan bill.
I would say that in my opinion, Obamacare was effectively a large expansion of Medicaid. Simply more subsidized, to the point of free, healthcare for people who qualified for it. A significant transfer of money from people who pay taxes to people who don’t. So yes, if the Ryan plan purported to stop that, it was, as Bernie Sanders and Elizabeth Warren were screaming, a tax cut for the rich. But as Jack has pointed out, you can’t ever take away an entitlement.
And Charles, ever since you were out of college and on your own, what’s been one of the primary things you tried to make sure you had? Good health insurance, most likely through your employer. It’s something that’s shaped the lives of responsible people in our generation for our entire lives. Has it been an unbearable burden? No. Do I want healthcare run by the people who are running the road department or the motor vehicle division or the IRS, for that matter? No thanks. Remember the term, “good enough for government work?” Do I want that when I need cataract surgery? No. I’d rather have a guy driving a Porsche, thank you very much.
Why must we assume the federal government is responsible for ensuring everyone is insured?
I ask that because we never test the underlying assumptions for doing “something”.
If States regulate both the insurance industry in their respective jurisdictions, license medical personnel, require certificates of need for new facilities and administer Medicaid, why shouldn’t the States decide how much it wants to subsidize its citizens. If the States had that responsibility then it would bring the consumer closer to the actual payer because it would force an annual examination of costs and benefits when state budgets are formulated. It would force legislators to actually prioritize the “somethings” they want.
Because States are typically required to balance their operating budgets, decisions become more ethical because they must spend current income on current expenditures instead of racking up mountains of debt that will come crashing down on the backs of our current children in the not too distant future.
If Blue States want to give generous benefits then the costs are borne by those who elect the legislators granting the benefits. If Red States choose something different and the people want more, individual personal mobility allows them to migrate to more suitable political jurisdictions. If an unaccompanied minor can migrate from El Savador to Minnesota nothing should stop an American family to migrate from one state to another. Everyone has options based on their wants and needs.
If people must have the federal government provide access to health care then economies of scale would dictate that the federal government “make” health care instead of “buying” it. Why the desire for single payer when single provider will do more to control costs. Nationalizing health care would mean that ALL medical personnel would be federal emoyees on fixed salaries and facilities would be controlled by the government. I’d like to see ole Bernie Sanders try to sell that.
I prefer the former because it will force an examination of what we can promise that is fiscally sound and maintains some semblance of consumer choice.
Thanks Chris. Or as I ask, why would anyone want to got to college, four years of medical school, three years of residency and then various internships to become a federal employee?
You could ask the same of any judge/ College, law school, then maybe a prosecutor or a firm or just working alone for years until someone adds their name to a list.
Ultimately if the work you want to do is government work then people will become federal employees. Though Chris marschner is wrong that nationalizing health care would make doctors employees. They could just as easily be contractors working sometimes for the government and some in non-covered areas. A cosmetic surgeon can still stick up wounds on Tuesdays.*
*This should go without saying but some commentators are rather dense. Explaining or theorizing about how something might work is not the same as advocacy.
Bad example. The legal system – interpreting and enforcing laws – must have a governmental component.
An equivalent example would be a bill that everyone must buy legal insurance so if they ever have the need for one, it will be provided for “free.” But can you keep your own lawyer?
No it is a perfect example. Your question was why would someone who has to spend a lot of time and money on schooling and then practice would want to be a government employee. There’s your answer, judges.
erm Chris marschner’s question. Sorry.
if that was what you were trying to show – that some people go through a lot of schooling to work for the government – then the examples are endless. Doctors, lawyers, bankers, rocket scientists, the list is endless. Not hard to come up with one.
I think the point is why would someone go through all that schooling and have no choice but to work for the government.
Plus, EO, science and math are hard. Medical school and pre med are hard. By comparison, the liberal arts and law school are easy. Let’s face it, right? Physicians can’t BS.
Bill, I agree nationalization would not make medicine an attractive option for some of not many.
I advocate for States to decide if and what subsidies exist. It prevents people from voting for subsidies with no immediate tax implications for they themselves. If socialist leaning States want to create their utopian environment let them but let them bear the costs. Same for right leaning states.
I write 5 paragraphs on why pushing health care costs back to the States makes sense and people focus is on my sarcastic last two paragraphs on nationalization.
Fed’s have the power to tax to give benefits and so do the States. Any supporter of federal subsidies should have no problem with their state legislators hiking taxes to give such support if the federal government does not.
…but don’t you feel better for having put your thoughts ‘on paper?’
I liked your reasoning.
Delete my repetitive post. Don’t know why there are two of the same
Chris, you make a very good point about states not being able to run deficits like the federal government can and does. But I think that safeguard has been enfeebled somewhat by the states having gotten in the habit of relying massively on federal grants and subsidies as a very significant part of their operating budgets. That would have to change or be avoided in the case of health insurance.
Oh! I thought it was for emphasis.
Oh! I thought it was for emphasis. No, really.