Bad things happen. Tragedies happen. When they happen, it’s good to help those affected, and it’s good to think about ways to prevent those things from happening again. If they can’t be prevented, it’s good to think about ways to protect us from the damage they cause in the future. These seem like normal responses, yet so often, doing these things gets blasted as an attempt to politicize a tragedy. I really don’t like that critique, and the critique itself seems to be more “political” than actually talking about solutions and prevention.
There are some things that I tend to say over and over. One of them is about the options, as I see them, when it comes to offering social services to a society. There is always going to be a group of people who we can agree are deserving of these services, and a group of people who take advantage of the services and get something they don’t deserve. In an ideal world, we will only give coverage to those who deserve it, and not one undeserving person will get benefits. This will reduce the costs to the lowest possible, because there is no waste in the system. Because the ideal never seems to be possible in an imperfect world, we have to pick which way we want to err. Do we want a system that covers the most people, or the fewest. The system that covers the most costs more, but makes sure that all the “deserving” get what they need, while unfortunately letting some of the “undeserving” take advantage of the system. The system that covers the fewest saves money, by making sure that no “undeserving” get help they need, but leaves some “deserving” without help they need. Of course we can also debate who is “deserving” and who isn’t, but that’s a separate issue (not unimportant, just separate). Nevertheless, the whole purpose of this post is to have a place for a graphic that I created to illustrate this. It’s rough, and I spent less than 10 minutes creating it, but here it is. Sharing is welcome, but it would be nice if a link to this post came with it.
Todd Starnes has a piece on FoxNews today about all the people who want to take Trump down. “Mainstream media, Dems, RINOS: They all want to overthrow Trump.” It’s a strange read to me. The premise (that all these people want Trump gone) doesn’t seem far from the truth, but the thing that gets me is the use of “RINO,” Republicans in name only.
The House of Representatives has voted, once again, to repeal the Affordable Care Act. This is not the first time they have done so, and it likely won’t be the last. They passed several bills and amendments since 2011 that repeal or limit Obamacare, and few of these became law. My guess is that this bill will die like the others have, but this time it will be killed by a more pensive (and smart?) Senate. Senate republicans are already saying that they can’t pass the current bill, and it’s not clear that they even have enough support for a vote. It’s hard to see how the House and President see this as a win, but they do, and they had a party at the White House about it. Vice President Pence rallied the crowd (of middle-aged to old white men) with a line, “Welcome to the beginning of the end of Obamacare.” Silly line. Doesn’t that assume that Obamacare will end? Doesn’t it assume that the previous votes weren’t the beginning of anything? Silliness all around.
I don’t know why, but I’m still trying to view the Trump administration through rational eyes. Perhaps there are several versions of rational. There really shouldn’t be, but maybe what I think is rational isn’t actually rational. I am saddened by what I see as missed opportunities (see here and here), but I’m starting to accept the fact that it’s never going to happen. I’m starting to accept the fact that we all have things that motivate us, and I think what motivates Trump has more to do with celebrity than anything else. That’s not inconsistent with doing good things for the country, but I’m not convinced that it’s what drives him. I can imagine that he can convince himself that it’s driving him, but I think deep down the things that he embraces are things that feed his celebrity status. I should be clear that I’m not saying that there’s no concern for others in that. I think he enjoys entertaining people. I think he likes it when they’re excited to see him. I think he thrives on that. There’s a level of admirable selflessness in that. Like the comic who stands on stage making fun of himself to make you laugh. On the other hand, it leads to some pretty strange moments when the President of the United States acts that way.
The scientist in me craves information. I want to know what’s going on and why. It’s undoubtedly what made science so attractive to me. It’s also what makes research with human subjects so unappealing to me. People lie, and can’t be trusted (of course I know that’s not entirely true, but when it comes to research, it’s a real problem and I’m continuously impressed by those who take on those problems). We know people lie because we see it all the time. This isn’t a misanthropic judgement, it’s just a statement about who we are. Most of it is unintentional, and we even lie to ourselves. How many times do we say that we don’t want to eat that last chocolate, but we eat it anyway? We say that we wanted to go to the gym, but we stayed on the couch instead. We become living contradictions. We have the verbal report (even the voice in our head) saying that want something (or don’t want something), but our behavior tells the opposite story. When faced with this contradiction, if we’re trying to figure out which is the real version (the not wanting to eat the chocolate, or the eating the chocolate), I think the behavior tells the real story. We may say or think that we don’t want to, and a piece of us might not want to, but if we eat the chocolate, we clearly wanted to more than we didn’t want to. To make it worse, how can I know if somebody is lying when they say that they don’t want to do something, but they do it anyway? Until we invent a mind-reader, and can be sure that we aren’t lying to ourselves, all I have is the action, and, to be as cliche as possible, actions speak louder than words. What makes me say this today? Sanctuary cities. It’s a stretch, but follow along if you want.
The GOP is busy trying to repeal and replace Obamacare. They’ve proposed the American Health Care Act as a means to that end. To be honest, I can’t seem to find the bill online anywhere, but the CBO has released its estimates of the impact (the CBO says it combines legislation, but it doesn’t say what legislation it combines). As an aside, in my search for the bill on congress.gov turned up H.R.277 (American Health Care Reform Act) that has collected 29 cosponsors), but also turned up H.R.1275, which has a much better name: “World’s Greatest Healthcare Plan.” I’m quite sure it’s not, but it’s still a great name.
I am not going to get into details about the CBO score, but the summary is that the plan will save Americans $337 billion over 10 years, at the cost of increasing the number of uninsured by 24 million. The CBO says that 14 million people will become uninsured by 2018, mostly because they will opt out of coverage after the mandate is repealed. People speaking in support of the plan have said that it will maintain coverage for pre-existing conditions for people who maintain continuous coverage, so it looks like these 14 million will lose that benefit of the ACA. By the end of the ten year estimate, the CBO says a total of 24 million more Americans will be without insurance, bringing the total uninsured to 52 million Americans. The impact of this could be devastating to those Americans, and we will watch them suffer, all to save some money. I think that’s a moral failure.