Wednesday, March 8, 2017

Obamacare-lite Debuts

I suppose that "repeal and replace" where Obamacare was concerned was always a pipe-dream. That is because, once the government has started a program it is almost impossible to stop it. The clients of the program will tear down the state rather than give up their free stuff.

So the Obamacare subsidies for people buying health insurance on the exchanges won't go away in the new Ryan health plan.

And there won't be a national health insurance market. And the special status of corporate health plans, with their tax-deductibility that puts individual plans into such a bind: that won't go away.

On the other hand the plan does propose to "do something" about Medicaid by moving to a per-capita grant from the Feds to the states instead of the current system.

It will be interesting to see what happens next, because conservatives and libertarians are outraged and naturally a chap like Sen. Chuck Schumer (D-NY) had his sound bite all ready. Said he:
Trumpcare doesn’t replace the Affordable Care Act, it forces millions of Americans to pay more for less care.
Chuck is probably right. Whenever the government changes its spending, it is going to make life easier for millions on the one hand, and make life harder for millions on the other hand.

And since tens of millions are getting a break from their corporate plans, and tens of millions a break from Medicaid, and tens of millions like me a break from Medicare you can see that there is not just one third rail that a politician doesn't want to touch, but several. Because I can tell you, all of us demand that nobody lay a finger on our health plans.

No doubt Rep. Paul Ryan (R-WI) and his assistants are trying to put together a plan that insulates him and the GOP from electric shock as far as possible.

And no doubt the master negotiator President Trump will get in the act to finalize the deal.

But I am trying to think about the bigger picture. How do we get out of the box canyon of the administrative state, where government programs and processes are almost impossible to adapt and change before the inevitable pileup into the canyon wall, as in Venezuela?

If you are an underappreciated genius, this would be the miracle of the ages. How to escape the civilizational cycle that ends up in financial collapse because the government has promised too much to too many people and can't reduce the free stuff for anyone.

There is one method that seems to work. You declare a group to be the enemy of all good people. Marx and Engels did a good number on the bourgeoisie back in the 19th century and created the space to tax and punish the bourgeoisie and make them pay for benefits for the working class. And modern liberals in the 1960s demonized whites as racists so they could dump the white working class and give benefits instead to blacks and women.

So who do we demonize so we can reduce the huge burden of the modern state? The liberals? The cognitive elite?

Maybe that is what Trumpism is doing, provoking the left's bully boys to come out into the streets and beat up women college professors, as at Middlebury College last week.

Frankly, I prefer the workings of the market. The worst thing it can do is drive you into bankruptcy. That is much gentler, and more civilized than the demonizing and Othering and "mostly peaceful" protests of the political world.

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