Friday, March 24, 2017

Paul Ryan's Francis Macomber Moment: That Undeserving 3%

Paul Ryan and his friends will probably prevail today, whatever that means.
Well, I guess we do know what that means: He'll get his bill through the House of Representatives, claim victory and Mr. Trump will go to Wisconsin and claim another "Promise Kept!"

What you got is the healthy paying for the unhealthy, and the poor. Bad idea!

It all reminds me of the idea which kept coming up during the war in Vietnam: Let's just declare victory and go home.

Or that wonderful Hemingway story: "The Short Happy Life of Francis Macomber," in which a rich man on safari raises his rifle to shoot a lion but loses his nerve, drops it and turns to run when the safari guide behind him raises his gun and shoots the lion dead. The native hired hands, who carry the rich mans baggage, who are paid by the rich man, then hoist him on their shoulders and carry him back to camp, as if he has had a great victory.

So, later today, Paul Ryan will have his Francis Macomber moment. Both he and President Trump will be carried off on the shoulders of the Congressional Republicans as victors.
It's going to be so great. You'll love it.

Health care, and the legislation affecting it,  is actually more complicated than Mr. Ryan or President Trump appreciate.  I certainly do not understand it.  But as we used to say at the hospital: The most dangerous intern is not the intern who doesn't know; it's the intern who doesn't know he doesn't know.

click to enlarge

One thing I've learned through all this is by far the vast majority of our citizens are not covered by Obamacare--only about 3% are--most people are covered by employee plans, Medicare or the Veterans Administration.  The 9 million or so who use Obamacare can easily be ignored, as they had been for generations, by the Republicans and all the members of Congress. The wonder is President Obama ever got anyone to vote to help them.

But there might have been a reason Democrats were able to get  Obamacare done:  Those uninsured people, as small a portion as they were,  kept showing up at emergency rooms, and the hospitals had to pay the doctors and nurses who took care of them in the ER's, in the hospital, and  in the operating rooms, and that burden ultimately got passed down a line of hands to the government and prices for everyone's health care premiums rose.

So you had this slow leak of the tire which kept getting in the way of the functioning of the whole car.

Seven years ago,  John Boehner finally blurted out his  greatest fear about the new Obamacare bill--If you give people a taste of health care, they'll never want to live without it.  
It was a version of that droll bit of wisdom I'd hear in the South all the time from the comfortable upper class country club types:  "Don't feed a stray dog: He'll follow you home."
Which, in case you missed it, means that once you show kindness to the hungry varmits, they'll become dependent on you, so never be kind or generous, it'll be a burden. He might be your brother, but he's really too heavy.

I promised we'd kill Obamacare and we did!
Without knowing the details of Obamacare, it seemed to me when I first heard about it, if you were going to tell insurance companies they had to insure all those sick people out there with pre existing conditions, who have not been able to get health insurance because they were sick and needed health care (the customers no insurance company wants) then you have to feed the insurance company a huge new pool of customers who will never need the insurance company to pay anything, namely healthy young people. But healthy young people are invincible and don't see any benefit to health insurance so you have to intimidate them to pay money for something they don't want.  That was the "mandate."

The basic flaw in the argument is that health insurance ought to be a commercial enterprise whose raison d'etre is to make a profit for investors in insurance companies.  Any business wants to take in as much money as possible while spending as little as possible. But the purpose of a hospital, a clinic is, in fact, to spend money, or actually, to provide services, which is pretty much the same thing.  So the idea of health care as a profit center is a contradiction. You are trying to make money while not doing the thing you are being paid to do.

And then you've got those young people, from whom you are trying to make your profit. It's the young, healthy, not needy from whom you extract your profit. Of course, those healthy young people are already unwillingly paying for stuff they would never pay for unless they were forced by law to do it: Social Security and Medicare.  We have those programs because the government discovered you have to force people to plan for the times when they will no longer be young, something no young person believes will ever happen. So we said, suck it up, you don't want to and you don't like it but we are not going to support you when, so we are going to make you eat your spinach now.

But the Freedom Caucus, Paul Ryan, the Tea Party want to say, Live Free and when you get sick, Die! They don't believe in no durned gov'ment making people behave like responsible adults and when those irresponsible adults show up at the Emergency Room with their I phones and their gold necklace bling, just turn them away. Serve 'em right.

Except some kind hearted do gooder liberal Emergency Room nurses let those folks in and the whole system goes to hell in a hand basket. So what we need is a law which puts the TSI agents out in front of the ER and they don't let anyone get through the gates unless they have health insurance.
Not a dog, but you get the idea.

Don't feed them stray dogs.


  1. Well-you didn't call this one correctly Mad Dog-Ryan and the Republicans didn't win the day. "Repeal and Replace" became "Retreat and Renege." Best of all is Trump's attempt to blame the Democrats in a convoluted, lame brain, excuse session in the oval office (with what looked like coffee pods or merit badges behind him). Even the lighting in the press conference screamed amateur hour..Donald's wimpy attempts to blame the Dems for the defeat is too mired in stupidity for even the staunchest Trumpee in Trumpville to buy..Bad day for Donny and Paulie..

  2. Maud,
    Yes! What WERE those things behind the President? I could not pay attention to him, trying to discern what those little round things were. Kuerig things? Merit badges? Those were my guesses, too. I'm so glad someone else noticed. I saw a metal statue which looked like Andrew Jackson, which would be appropriate. But the coffee pods? Would the President drink Kuerig? He is a teetotaler I know, but coffee from pods?
    Oh, well, that's the art of the deal, moving on to other things.
    Mad Dog