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Lessons from the Health Plan Collapse

The depth of the loss is probably exaggerated.  It is still very early in the term of this administration and the humiliation will subside. Still, there are some harsh lessons that should be learned .

President Trump may have found the limits of bluster.  When it comes to critical policy, the details do matter; you cannot just declare that your bill will be great.

The ACA front loaded the benefits and rear loaded the costs. The Republicans found it tough to take away benefits.  Like bricks on a pickup truck, we keep adding bricks beyond the load capacity and then only blame the last few bricks when the axle snaps.  The problem with health care is an accumulation of mandates, regulations, perverse tax incentives, and wishful thinking. It is a Rube Goldberg cluster of attempts to hide the true costs of health care, so that politicians can make promises without paying for it.

Apparently, the Republican opposition to this bill was that they were not removing enough bricks from the truck.  Perhaps they need a heavier duty truck with a bigger load capacity. For the left that means single payer, but that only further hides true costs by removing the function of prices and incentives. For me it means restoring consumer power and facing economic reality. Insurance is not health care, mandates cost money, and restricting supply while increasing demand and money flow will cost you somehow.  This is the economic equivalent of gravity.

Perhaps the mistake was to take a systemic approach rather than address the component problems in separate bills.  Cost and access are related, but require very difference approaches.  In the focus on cost and access we do not want to sacrifice  innovation, quality and service.

The Republicans who have swept state governments and shown much fiscal success in that arena are facing much greater obstacles with national power.  The difficulty of assembling a collation on a national level is much different. Lawmakers must address fears and concerns that may be much less prevalent in their district. Senators and Congressmen face a powerful national media that local lawmakers usually avoid.  This is a fact to be accepted and requires an exceptional ability to communicate concepts of policy in commonly understood language.  Coverage with no providers is not a solution.  Lower premiums with outrageous deductibles is not cheaper.

As Glenn Harlan Reynold notes, the Republicans should have their health care bill, their tax reform plan, and their infrastructure bills lined up like planes on a runway. The reality of passing legislation is more complicated, but they are better off failing early, if they learn from it and keep pushing.

They will not succeed by rushing, blustering, and sacrificing transparency.  If they repeat the mistakes of the last administration they will reap the same rewards.

Other recommended readings on health care reform

It’s time to drag healthcare out of the 19th century

Supply Side Health Care Reform

Ditch Obamacare and Don’t stop there

Republicans Should Kill Obamacare or Let it Die

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Unacceptable Decency

A gem from Kevin Williamson at National Review, Fake Hate Crimes:

The Left desperately wants Americans to be indecent people who go around attacking Muslims and foreigners with funny names, but, by and large, we aren’t. Campus feminists desperately want “rape culture” to be a reality, and so they invent phony rape stories from Duke to the University of Virginia, making sure to target fraternities and sports teams, which are to them symbols of patriarchy. These stories are given currency and credence by incompetent journalists such as Sabrina Erdely and her editors at Rolling Stone, none of whom had the intelligence or grit to question the transparently false claims made in “A Rape on Campus.”

Here is the thing: It is not only the hate crimes that are fake. For the most part, the hate they are intended to highlight is fake, too. No matter how many times Jamelle Bouie of Slate insists that American conservatism is an ideology founded in white supremacy, no matter how many times the halfwits at Salon claim that the neo-Confederate impulse is the motive behind Republican policy ideas, no matter how passionately every third-rate intellectual from Bennington College believes that “all heterosexual sex is rape,” it is not so. These claims are as fictitious as the made-up rape at the University of Virginia — they are simply more general.


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Origin of ‘Neoconservative’

from Word Games by Kevin Williamson in National Review

“Neoconservative” was first brought to popular usage in the American context by left-wing intellectuals (the socialist Michael Harrington most prominent among them) to describe the thinking of a few critics of American progressivism and the American Left — especially Irving Kristol and Daniel Patrick Moynihan — who didn’t smell like conservatives. The classical conservative — the cartoon conservative — was Babbitt, a Midwestern businessman who was Republican, conformist, and, above all, anti-intellectual. Kristol was a Jewish intellectual from New York and a former Trotskyist; Moynihan was a Kennedy confidante, a diplomat, and, eventually, a Democratic senator. The neoconservatives, in essence, were those who began criticizing progressivism from within. Eventually Irving Kristol and Norman Podhoretz, among others, would embrace the label.

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The Mythical Will of the People

From Kevin Williamson at National Review, The Anglo-Americans:

Populism takes a different view: At the center of its concerns is the people — or, increasingly, the People. If populism meant only being good at the real-world application of democratic politics, that would be only an acknowledgment of the political reality that you have to win to govern. But it is not that. It is rather the latest reincarnation of Jean-Jacques Rousseau’s “general will,” that nebulous motive that is the will of the People as interpreted by men with power, as opposed to the will of the People as revealed by what the People do when left to make their own choices and to bear the responsibility for those choices. We are always fighting the French Revolution, in one form or another.

The fundamentally irresponsible nature of the general will is one of the reasons we have a representative form of government rather than a strictly democratic one. But representation itself is held in some suspicion by the populists. If you ask someone, “What ought Representative Smith to do about this problem?” the answer you will usually get is: “He ought to do whatever his constituents want him to do, whatever the People want him to do.”

But that is exactly wrong: What he ought to do is not what the People want, but what is best for them: If there were no difference, then the representative would not be necessary — and neither would the Constitution. In reality, neither the emancipation of slaves in the 19th century nor freedom of speech in the 21st century would have survived a plebiscite. Neither would free trade, if we held the vote tomorrow, because the general will demands protection from a government that is, in John Kasich’s ghastly phrase, “America’s Dad.” It is strange that in the case of political representation, trusteeship is considered by so many condescending, whereas outright patronage is not considered patronizing.


Kevin treads into the critical difference between a republic and a democracy.  Progressivism is like socialism and fascism in their belief in a mythical general will.  Bending those who do not comply with the will of the people are subject to the power of government to force compliance. Democracy evolves into tyranny when we realize that the general will is not voiced from the people but TO the people by men in power. Democracy and demagogue share the same root.

Free market capitalism is a much more honest expression of the will of the people.

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The Intellectual Ghetto

Over the years, I discovered the difficulty of conversation with some people.  Interruptions can be annoying and often rude, but it often seems justified by a long-winded response or statement. We should avoid interruptions, but we should also avoid monopolizing the conversation.  A point of view should not be expanded into a lecture or a sermon; the difference being the imposition of moral supremacy. Shallow moral supremacy has earned the term ‘virtue signaling.’

Try this trick; when one does interrupt, avoid the temptation to elevate your voice and talk over them. Just stop talking. See if they return to you and ask you to complete your point.  I will bet that 90% of the time they do not.  This means they were not listening to you or uninterested in whatever you had to say.  If this happens more than a few times you will seek to avoid conversation with this person in the future.

Good conversationalists are interested in understanding before they seek to be understood.  Most just seek to be confirmed in their view.  This leads to our own conversational bubbles, a form of a self-induced intellectual ghetto.

On a larger scale this occurs in our national political conversation.  In an election that surprised so many, it is disconcerting how reluctant many are to try to understand what happened.  Many have fallen for blaming nefarious activities and conspiracy theories to avoid any consideration of an ideological shift.

Obama’s first victory was much easier to accept. The combination of the ill-fated Iraq War and the economic collapse on election eve constituted an insurmountable barrier.  But there were similar claims and conspiracies about Obama, beginning but not ending with the birther nonsense.  Some of us who considered his election a circumstantial fluke had to reconsider when he was re-elected.

Perhaps history, like economics, moves in cycles.  Adversity breeds action, action breeds success, success breeds complacency, and complacency breads collapse and adversity.

Listening with the intent to understand is the ultimate sign of respect. Without it we just increase our isolation and partisanship.  Demonizing and attributing pathologies to opposing views is just another way of not listening.