Republicans Continue Attempts to Thwart Republican Health Plan

So, the Republicans in Congress continue to strain every fiber of their being and every last cent of the Koch brothers’ carbon-based loot in their valiant effort to fight off—the Republican Health Care Plan. Yes, the evil Obamacare, its nefarious schemes unmasked to all in a Web video recently that showed a leering Uncle Sam preparing to do a pelvic exam, was for the past TWO DECADES—the Republican Health Care Plan. Yes, it’s a Republican baby, paternity confirmed on public record, conceived in response to the Clinton health care plan of 1993, and built on the foundation of an individual mandate to purchase insurance from private insurance companies. A Republican governor (what was his name again?) actually implemented this plan and Republicans continued to advocate for it—right up until the time a Democratic president proposed it in the apparently mistaken belief that Congressional Republicans could at least be persuaded to vote for a Congressional Republican program. “Hah! Consistency? We spit on consistency! Though foolish consistency is the hobgoblin of small minds, and we have small minds, and are foolish, we reject consistency as it is much less important than denying health care to the poor and a victory to the Muslim president whose socialist plan will result in a windfall of profits for private insurance companies and…Never mind! Remember what we said about consistency!”

The history of the Republican plan was described by Ezra Klein in the New Yorker. Briefly, in 1989 the Heritage Foundation published “Assuring Affordable Health Care for All Americans,” which suggested that all individuals be required to purchase health insurance (like they must auto insurance). Then in 1993, as an alternative to the Clinton plan, the Republicans included the individual mandate in their Health Equity and Access Reform Today Act (sponsored by John Chafee, RI and co-sponsored by 18 Republicans). In 2006, Sen. Ron Wyden (D, OR) and Bob Bennett (R, UT) sponsored the Healthy Americans Act (11 R and 9 D co-sponsors). Broad Republican support. No Uncle Sam ob/gyn videos…until president Obama changed his mind in 2009 and used the Republican plan to design the Patient Protection and Affordable Care Act. Then the blue-blooded, rock-ribbed Republican baby morphed into the evil Obamacare.

So what exactly is in Obamacare that inspires such vitriol and hatred from Republicans? What makes Georgia state insurance commissioner, Ralph T. Hudgens, say he will do “everything in our power to be an obstructionist.” Well, Obamacare tries to help poor people, and that ought to be enough right there, don’t you think? But besides that, what’s in the plan? Fasten your seatbelts, folks, and raise the blast shields, because here’s a straight look into the maw of hell that is Obamacare, which proposes to:

  • Prevent insurers from denying coverage or charging higher premiums to those with preexisting conditions, and from rescinding coverage after people have required expensive care
  • Require plans to cover preventive services without cost-sharing (deductibles)
  • Allow children to remain on their parents’ insurance up to age 26
  • Eliminate lifetime limits on coverage
  • Raise Medicaid eligibility to 138% of federal poverty level
  • Create health insurance exchanges in which people without employer or Medicaid coverage can buy insurance (and cost-sharing for some of those who need help paying for it)
  • Require everyone to have health insurance beginning in 2014 (the individual mandate)
  • Require plans to spend at least 80% of premiums on actual medical costs
  • Penalize employers that do not offer affordable coverage to their employees (with exceptions for small employers)

OMG! OMG! Insurers can’t drop you when you get sick or get so sick that you cost too much! They can’t deny you coverage because you had asthma when you were young? They have to spend 80% of the premium money you pay them on actual medical care (note that Medicare spends 96% on medical care)? Help, help! Call the Thought Police!

You know, I’ve looked at more detailed summaries of Obamacare (see this summary from the Kaiser Foundation) and I’m still looking for the evil. The only evil I can come up with is that it’s not Medicare for All—but that’s because it’s a Republican plan, now isn’t it?

The Ruse in Syria

Well, if the dodgers and duckers in Congress are going to take a position on Syria, then I guess I should as well. Here goes. Basically, I think the chemical weapons issue is really just an excuse to mobilize public (and Congressional) opinion behind a regime change operation—or I should say, an attempt at regime change. I think this is highly likely to end poorly for the US and rather likely to end poorly for most Syrians. Thus I am opposed to both what is apparently being proposed (limited air strikes aimed at degrading Assad’s chemical capability and deterring him from using them) as well as the hidden agenda that I think is actually being planned (unlimited attacks plus whatever aid and assistance to the rebels it takes to bring down the regime—essentially Libya v2). Here’s what’s wrong.
Chemicals a ruse: I’m as reluctant as anyone to underestimate the stupidity of politicians but the alleged rationale goes far beyond the borders of even American political logic and reason. Kerry and Obama have specifically stated that our only goal is to stop the Syrian government from using chemical weapons again. That’s the only casus belli; we’re not intervening to stop civil war and civilian massacres (then we would have to explain why we haven’t intervened in even bloodier wars in Africa), we’re not trying to bring democracy to yet another Muslim country. No, we’re just enforcing the international ban on use of chemical weapons. That’s all folks!
This is nonsensical because by our own arguments, we would therefore have to consider it “mission accomplished” if Assad used no more chemical weapons but accelerated his pace of shooting, shelling and bombing his people. Our “logic” is such that 10,000 dead by conventional means but no chemical casualties is more of a “win” than 1,000 dead by nerve gas. Really? That’s a preposterous ethical judgment. Not even US politicians could believe that—and I don’t think they do. Is this just verbal quibbling? No, assuming for a minute that we do “persuade” Assad to stop using chemicals, is he just going to give up and move into exile? I suppose that’s a theoretical possibility, but I think it’s much more likely that he’ll accelerate his conventional attacks in order to crush the rebellion quickly before we decide to intervene further. More deaths will ensue. I suspect that this likelihood is planned for by the White House, perhaps even counted on. Once Assad escalates his butchery, it will be easier to sell the public on the case for more direct action. That’s the only reason I can see that we would maintain the otherwise irrational prioritization that dying in agony in the street from a bullet through your abdomen or being burned alive trapped in the ruins of your bombed house is so much more acceptable than being killed by nerve gas.
Why it’s likely to end poorly for us: I know we’d all like to see the Syrian butchery stop, and if Harry Potter showed up with his magic wand, we would all insist he wave it. However, there’s no magic wand; there’s only military force, and before we pull out the sword (or before we do anything, really), we’re obliged by the standards of rationality to weigh the risks/costs vs the benefits.
Now, Kerry and all the spokespeople have tried to do an end-run around the need to make this assessment by saying, “The worst that can happen if we fail to act is that things continue as they are.” Really? You’re telling us this is a military attack with no downside? Only good things could come of this? The risk is zero, so it’s all benefits? That’s the same failure of anticipation that got us into trouble in Iraq. Even though I don’t think Kerry and Co. actually believe this, no one on the shows where they made these claims (all this past weekend) or in commentary afterwards challenged this absurdity, so let me help them by listing a few of the possible downsides of our (ostensibly limited) bombing of Syria:
• Increased killing of civilians by conventional means (by Assad as per above, plus whatever ones we kill ourselves)
• Increased Muslim anger due to yet another US military intervention in yet another Muslim country leading to further East-West polarization, more Muslim radicalization and more terror attacks on the US
• Increased likelihood of equally direct intervention by Assad’s supporters, Iran and Russia, escalating the conflict from an internal Syrian one to a regional if not international one
• And if greater intervention does manage to drive Assad out, the subsequent regime is likely to be equally repressive and non-democratic but more Muslim extremist (and likely to commit atrocities on government supporters, particularly the Alawites)
Possible upsides?
• The attacks somehow convince Assad to negotiate with the rebels who, despite all current appearances, somehow unite into a coherent bargaining force that can find enough common cause with each other and their opponents to participate in forming a stable government
• The US looks like a champ for bringing an end to a war that no one seems happy with (including the participants)
I think the downsides are highly undesirable and the upsides are highly desirable, but I find the downsides much more likely than the upsides, and thus I come down against unilateral US attacks on Syrian installations (if you want to talk about things that the world could do as a united front to help solve the problem, that’s a different issue from what is now being proposed by the White House and a matter for another essay).