The 300-Million Payer System

In this case I would say its not because the president signed it into law. It’s because that’s what the lunatic base wants to hear.

Newt is intelligent enough to know the truth, but evil enough to lie through his teeth and deceive his would-be supporters to any extent necessary. In some respects I’d say that makes him worse than the other candidates who are simply ignorant. It also makes him the worst kind of politician there is.

Anything Newt says has to be viewed through a prism of cynical pandering.

Most of us who don’t suffer from political amnesia have known for some time that the Affordable Care Act is really just a warmed-over rehash of the Health Equity and Access Reform Today (“HEART”) Act of 1993, a.k.a. Bob Dole and the GOP’s alternative to “Hillarycare.” We also know that such a plan was endorsed as recently as 2006 by the right-wing talking-point factory the Heritage Foundation.

I’m trying to think of a recent example of Democrats so thoroughly, aggressively and vehemently rejecting what was once their own idea or proposal when, and because, it was subsequently proposed and/or enacted by a Republican president. Is it fair to point out the various Democrats’ statements in the 1990s that Saddam Hussein ought to be taken out, and compare that to this? I don’t think so; even if they did cynically change their stripes on that issue, which I don’t concede, I don’t think that a pre-emptive invasion of Iraq was ever, or could reasonably be considered, a Democratic idea. (That, of course, hasn’t stopped some right-wingers from blaming the Iraq invasion on Democrats, but that’s a separate issue…)

Republican politicians like Grand Nagus Newt learned some time ago that they are under absolutely no obligation to be honest, truthful or consistent in their public statements, and they therefore feel no compunction to do so and no shame, embarrassment or risk in not doing so. The unbridled hatred their base harbors for this president is built on a foundation of pure fiction, of mischaracterizations of the man, of events, and of reality, of irrational but self-justifying and self-perpetuating prejudices, of unserious and irresponsible rhetorical excess, and to some extent on plain, outright lies. What the rest of us see as absurd, delusional nonsense, the Republican base sees as self-evident truth. When your fans are that devoted to you, and so thoroughly repulsed by your opponents, your moral hazard is practically zero.

But there may be a more sinister element at work here. Since we know the mandate/exchange/subsidy system embodied by the PPACA was a Republican idea endorsed by major conservative think-tanks as recently as five years ago, which now that it’s become law courtesy of a Democratic Congress and president is suddenly the most egregious and freedom-destroying display of unconstitutional federal-government tyranny in the history of the republic, the obvious question is, what’s the Republican alternative to this Republican idea? When you ask, they’ll say “market-based solutions,” but what does that mean?

Here’s what it means: No “market-based solution” that is in any way consistent with the GOP and its fans’ rhetoric on this issue could possibly have the goal, let alone the result, of expanding access and lowering patient costs. The only way to accomplish that is by collective action, by law, i.e., by “government.” Either we insure everyone directly through a collective, national insurance pool (like everyone else in the world does), or we require everyone by law to insure their own medical risk. Neither of these, strictly speaking, is a “market-based solution.”

No; the only “market-based solution” is to restrict access to health care to those who can afford it, and exclude those who can’t afford it from getting it. Expanding access requires those who can afford care to subsidize those who can’t, regardless of how it’s ultimately done. In the “market,” people who can’t afford something don’t get it, period, and whoever is selling it wants first and foremost to make the most money, not necessarily to make it affordable to the largest number of people. The latter has to follow the former, not vice-versa.

So, the Republican alternative to the Republican alternative is simple: Stop treating the uninsured and let them suffer and die if they can’t afford medical treatment. It’s their own fault, after all, for being too stupid and lazy to make enough money to address their own medical needs. And the main reason why health care is so expensive is that the system, under EMTALA (inter alia), has to provide emergency care for those who need it whether they can pay or not.

If the Republicans were both serious and honest about this issue, they’d be proposing two things:

1. Repeal not the Affordable Care Act, but EMTALA.

2. Get the states to start prosecuting people criminally, under theft-of-services statutes, for calling 911 or showing up at an ER without insurance or assets.

Let’s see what the Grand Nagus proposes to “replace” “Obamacare” with. Somehow I doubt he has any idea.