Trumpcare failed because....?

    Sure , for a mixture reasons.

    The Koch Brothers have wanted an outright repeal. End of story, And some of the Freedom Caucus presumably did too.  Maybe even because that´s what the Kochies wanted, 

    And out of  whatever personal characteristic I want to  believe- and do- that  some Republicans are simply decent people who while marching in lock step were still   nursing a secret hope their team would fail. 

    And , finally , some have the drunk the kool aid and believe the party line: That Ryancare would be an improvement. 

    It'ĺl be interesting to read the ¨exit polls.¨


    Flavius... The public knew it sucked...

    And the weasels knew full well they'd be run out of office on a rail by the voters.

    Poll: Just 17 percent of voters back ObamaCare repeal plan | TheHill
    2 days ago - A majority of American voters oppose the Republicans' plan to repeal and replace ObamaCare, while very few voters support it, a new poll finds. A poll published Thursday by Quinnipiac University found that 56 percent of voters disapprove of the GOP healthcare plan, while just 17 ...

    Obamacare Repeal: Only 17 Percent of Voters Back Bill |
    2 days ago - The Republican health care bill got some bad news on the day the House is scheduled to vote: Only 17 percent of American voters approve of ...

    Only 17 Percent of Public Supports Republican ACA Repeal Bill As ...
    21 hours ago - Only 17 Percent of Public Supports Republican ACA Repeal Bill As ... Trump's threat to move away from supporting Obamacare repeal is not ...
    2 days ago - A very small minority of U.S. voters, just 17 percent of them, support the Republican plan to repeal and replace key parts of Obamacare, while ...
    Repeal cuts taxes for millionaires, even if millions lose insurance. ... Updated by Matthew [email protected] Jan 17, 2017, 8:00am EST .... The 3.8 percent tax on net investment income (money made from owning or selling ...
    2 days ago - American voters disapprove 56 - 17 percent, with 26 percent undecided, ... replace Obamacare with the Republican health care plan, 46 percent of ... should repeal all of the Affordable Care Act (ACA), 20 percent of voters say.

    Mar 14, 2017 - Republican plan to repeal Obamacare would leave millions .... to help restrain U.S. healthcare spending, which is about 17 percent of the ...



    It certainly can seem that something fishy has gone on here when one looks at it in hindsight..

    While the entire country was, not just distracted, but made dizzy and disoriented by a spinning shiny thing called President Trump, the House tries to ram through a bill with detailed changes to the entire health care system with a plan that no one has read much less polled. A bill that not a single Congressperson has run on or made a promise about. All the professional organizations affected are surprised as they haven't been consulted for input. A bunch of  like, interns, no one really knows who, are said to be working to tweak it in some basement with White House staff. Rand Paul does a big P.R. stunt trying to find the bill. Even Newt Gingrich is fooled until the last minute and then sees the poll and slaps himself and says "Have we forgotten everything Reagan taught us?" Etc. etc.

    But at the same time, I think of what I use to say to people with complicated conspiracy theories about the Bush invasion of Iraq: which is it, he can't be both an evil genius and a stupid fool?

    Maybe there is just yuge incompetence all around and savvy parties like the Koch Bros are taking advantage. As the painter formerly known as President George Bush used to say: this governing thing is hard work.

    This Politico story is a very good step-by-step read on "What Happened?" in the whip the vote process. It's picture of all kinds of GOP slowly coming to their senses: Inside the GOP’s Health Care Debacle; Eighteen days that shook the Republican Party—and humbled a president. Even some of the Koch's minions were confused for a short while about what they wanted. One thing seems sure: Trump is not going to read much less study any bill he is pushing, he is going to be going totally on what others tell him about it. That's why he was purportedly yelling yesterday: Jared, why weren't you here? This too: his ability to deal and threaten has just taken a big hit? He isn't going to unify a damn thing about the GOP?

    "He can't be both an evil genius and a stupid fool?" - well, that's the whole premise for the movie The Prestige - the stupid fool has a secret evil genius twin. Okay, not exactly, but somewhat...

    Jared & Ivanka are a distraction, playing off the "buy one, get one free" mythos. Here it's more like "fool me once, fool me thrice".

    The NYT now has up some "what happened" articles like the Politico story:

    How the Health Care Vote Fell Apart, Step by Step


    The 33 Republicans Who Stopped the Bill

    They were united in their resistance, but from opposite ends of the spectrum.

    And Wonkblog @ WaPo does a really good job of explaining the real Ryan big picture plan vis a vis the health care bill being a sort of Trojan horse to get the tax bill going on the path he wanted, hence the hurry.

    So we should be grateful to the ten ¨Tuesday Group¨ Republicans who said ¨No¨ for the right reasons.

    I am.


    and a special shout out to Rep. Freylinghuysen in hopes that he will also think of his constituents when tax bill time comes around....

    Women a big winner - being female a pre-existing condition? This wasn't abortion or birth control - the cynical (male) bastards tried to cut all maternity benefits. That affect or offends over 50% of their constituency, even conservatives. Too stupd to drive fortunately - the Freedom Nutcakes don't even fathom how to breed.

    yeah really, who the hell put that on that list? no pre-natal or maternity, it's like > yes, killing babies before they are born

    I recall when I was young, that wasn't covered on most health insurance which was basically really just hospital insurance. You had to pay for your doctor's visits yourself. And they would let you have credit, you could be in hock to the doc for years for getting your wife pregnant. And I also recall that people were always talking about miscarriages. This is what they really want back: the 1950's. Hello, that is not the recent past anymore, it's now 2017.

    Even guys understand they're often on the hook for that delivery, and pretty much everyone knows a potential bankrupting birth-gone-wrong. Maybe if the only voters were unmarried 21-year-old dudes it'd work, but men calculate car insurance - the analogy of mandatory no-fault to high risk minimum coverage policies isn't quite lost on this bunch.

    I may be older than you (probably am), but when my mother had my sister she was in the hospital for 3 weeks!  There was never a mention of cost, and my family always considered themselves "poor."  My father worked for the US Post Office, but benefits were not so hotly contested then.   ( he was a lawyer, btw)

    Oh yes once you were hospitalized everything was usually covered without question. And people in big unions often had lots of coverage outside the hospital for primary care. But if you weren't in a big union, what you had was Blue Cross, Blue Shield for hospitalization and you paid for regular care yourself. And those pregnant that didn't have the money or "credit" for that, the first they'd see a doc might be for delivery.

    Most of my point in even bringing this up, I guess, is that pre-natal wasn't covered that much, and that at the same time, people suffered a lot of miscarriages. Aggressive pre-natal was actually a relatively new field--struck me watching the 1951 movie Father's Little Dividend some hay is made of the fact that the pregnant LIz Taylor insists on seeing a young doctor who has a lot of crazy new radical ideas about heatlhy mom making for healthy babies and (gasp) natural childbirth.. Because, you know, the doctors had a good factory system going for doing this delivery thing and they didn't need any help from the wimmin on that.

    I think that what the Freedom Caucus would like to see in going to a unregulated system is bascially going back to that. I've seen the argument that they think prices worldwide have escalated because people aren't forced to shop for their health care with their own dollars. There is no recognition in that of what technology has wrought in medicine since the 1950's and furthermore, no recognition that the most money is spent in hospitals by people who don't get primary care. They want insurance to be like car insurance, only kicking in with disaster. That's not the way medicine works now, it's just the opposite, it escalates costs when people are always trying to be cheap on keeping themselves healthy day to day.

    Actually, personally I myself would have nothing against having an option like that, if it didn't hurt the whole system. Because I don't like having things like a gatekeeper and like to do my own preventive care. But as we have seen, a system that leaves healthy young people to do the same makes everything more expensive for everyone. I like how it works with national health, where you can access the system, or go outside it to pay out of pocket. I think ultra conservatives are stupid in not seeing that what they want is staring them right in the face in universal national health care where it is not required that people use it.

    Do I remember correctly that you were sort of in a related field, along the lines of helping people make babies?

    Yes, I worked in Reproductive Medicine, (infertility, including IVF), trying to get people pregnant.  Prior to that I worked as a nurse practitioner in a college health service (basically trying very hard to keep people from getting pregnant.  One thing I learned from working in college health is how inexpensively good care can be delivered. 

    BTW, I remember your atavar, and for a very long time I was struck by how much you resembled Barack Obama!!!!  Hard to believe, but true!

    Why it failed?

    Maybe because a child was driving this bus?

    Because a child was driving the bus?

    Helpful inside White House baseball by Glenn Thrush & Maggie Haberman @ NYT today

    Trump Becomes Ensnared in Fiery G.O.P. Civil War

    Where Trump, Bannon, Priebus, Short, (Democrat) Cohn, Price, Pence, Mulvaney and Kushner were on the effort and where they might be now vis-a-vis Ryan, the Freedom Caucus and the rest of Congress.

    (Both reporters working their leakers. A reminder that Maggie was one of the 2 to get a call from Trump on this; Glenn is the White House beat guy who was immortalized on SNL sketch of Sean Spicer)

    And then there is this excellent prognostication published this morning at WaPo by Paul Kane on the House aftereffects, it's #1 on their story list right now:

    A new dynamic may be emerging in the House: A right and left flank within the GOP willing to buck leadership

    Conservative opposition to the health-care overhaul was no surprise. A promise of a “no” vote from the Appropriations Committee chairman was something else.


    Reporters keep discussing this like Trump is a relatively normal president and these are normal times. They act as if Trump and his team will think about what went down and re-evaluate how to move forward. That's all just fucking nonsense.

    Sure there was a conflict within the republican house. Trump didn't get ensnared in it. He was barely involved in it. He flapped his jaw on the campaign trail telling people what they wanted to hear without giving a nanosecond of thought to whether it was possible or how to accomplish it. He was totally uninvolved in preparing the AHCA and clueless about what it contained when it was written by Ryan and his aids. He made a couple of tweets about how great it was and a couple of threats to a couple of representatives to try to bully them into a yes vote. He met with a group of Freedom Caucus members but was incapable of any negotiations at all because he's had absolutely no knowledge of the contents of the bill and is clueless on health care policy issues.

    Trump doesn't face a wrenching choice: retrenchment or realignment. That would only affect a president that had a policy vision for the future of America. Trump has no ideology. He has no set of policy proposals he cares about. Everything he said on the campaign trail was just jaw flapping for cheers from the crowd.

    They say tax reform is next on the list. Trump doesn't care about tax reform except how it might affect the taxes he pays. He's clueless about how tax policy affects the nation as a whole and doesn't care to learn about it. He has no grand plan to help the economy or increase GDP or create jobs with wise targeted tax cuts. He doesn't care about any of that. He's not thinking about what his tax reform bill should contain or what  he needs to do to get his tax reform bill passed because he has no tax reform bill, no interest in creating one, and not a clue about about the issues he'd need to consider if he gave a damn about it.

    There's nothing about this that is normal and we can't put it into a normal box to talk about it.

    Great points but ones that make it all the more important to understand what Congress is up to and how any machinations by Trump's minions might affect (or not, after this) what they do.

    Basically what seems to be likely now: Congress comes up with wack stuff that half of it doesn't like and the White House will complicate the situation further with basically "tweets" on some particular talking point of interest to Trump agitprop, which won't be true and won't have much to do with the main affects of the bill.

    Which begs the question: did Bannon chaos theory mean to start with blowing up the Republican party? So ironic when they have finally gained control of both the presidency and Congress.

    Also, if they don't attempt to do something he can call a "infrastructure" bill and a "wall" bill, the two things he does seem to care about, what happens then?

    I'm watching the show and trying to figure out what the bunch of incompetents in the WH actually want to do. I imagine that eventually the republicans in congress will start to get it together. Is there really anything Trump cares about? I don't think he really cares about the unemployed. He just grasped what he needed to say to get them to cheer at his rallies. At some point he probably saw some fox news pundit talk about public/private partnerships to build infrastructure without massive government spending and decided that was a good idea. He never studied the details of how that might work or the trade offs involved in creating such a plan. He might care about it on the level of, I said I'd have an infrastructure plan so I guess now I'll have to try and do it I suppose.

    Does he care about a wall? I doubt it. It's not like he spent some time considering the problem of illegal immigration. He never considered the possible solutions and came to the conclusion that building a wall would be an effective way of controlling it. He never considered the costs or difficulties of building it. He never even thought about basic facts like much of the land the wall would be built on is owned by private citizens and would have to be seized by eminent domain and paid for. All he thought about was what would get the people to cheer. He might push the republicans in congress to do the policy work to create a bill that would fund a wall. Not because he cares but because he talked about it on the campaign trail.

    More and more this is looking like just another reality tv show for Trump. He wants to get good ratings and be popular. He'd like to win in the end. He doesn't have some broad vision of the policy he liked to see enacted. He doesn't care about all the pesky little details of crafting a policy proposal. He doesn't care about the politics involved in getting people to vote for whatever policy the republicans come up with.

    I'm not trying to be contrary or to disparage those trying to figure this out. But it's looking to me that Trump is just a little man with little concerns and little intelligence and little knowledge and little desire to do any of the work of being president. At best we can hope for triviality and incompetence from the WH. At worse vicious lashing out and not just on twitter.

    Republicans wonder whether Trump's heart was in healthcare fight

    The top Republican said that in one healthcare meeting with the president and his top aides in the Oval Office, it was a challenge to keep Trump focused on the health care vote. "Halfway through that meeting, he stopped to talk about Gorsuch,” the source said. “His mind was bouncing around. I never felt they were dialed into this."

     This is what I expect from Trump. This is the Trump I see at his rallies. Stream of consciousness without focus. Easily distracted. Jumping from subject to subject without finishing a thought. Obsessed with trivia. Why would anyone expect him to buckle down and get to work. To put sustained effort into some policy issue to see it through from start to finish when he's never given any deep thought to any issue beyond a campaign slogan. If the republicans in congress get it together to pass legislation that's what we'll get. Trump will be mostly uninvolved while he plays with his twitter and reacts emotionally to events in the news that personally affects him. Bannon might be able to manipulate him now and then but he can't control him or get him to concentrate on policy issues he doesn't understand or care about.

    That is a very interesting quote and article!

    Even if the sources are imagining things, that they think that. That they think that enough to complain to journalists.Who they know will write an article on it.

    This should be noted too, though it is all a part of the problem (intended?) of rushing it through:

    Republicans trying to understand what went wrong on Saturday also pointed to the fact that the two lead negotiators on Trump’s team, Health and Human Services Secretary Tom Price and Budget Director Mick Mulvaney, were slowed down by delayed confirmations. Price was only confirmed on Feb. 10, and Mulvaney was confirmed a week later, which prevented them from being totally devoted to the health care cause.

    Had Trumpcare (Ryancare?) passed   this discussion of its losers and winners ( winners?) would have had to share eye ball time with the analysis of the deal maker´s first big one. 

    No deal.

     So not exactly that same division  of eye labor. Kind of boring , for  a supporter to read about the tactics employed in pursuit  of a deal that newer was.  So by default we´re  hearing less about the failed game plan  and more about what was in the damn thing. Which may make it a tougher  campaign for  the son of ¨Trumpcare down the road..


    A recommended answer

    ....So why did Republicans fail? In a word: insincerity.... For all their endless warnings about how Obama’s signature health law was hurting American families, driving up costs and putting us on the path toward socialism, it turns out they didn’t care enough to put in the work.

    Harold Pollock @ Politico, March 25

    (Harold Pollack teaches social service administration at the University of Chicago. A fellow of the Century Foundation, he’s a regular contributor to the Washington Post’s Wonkblog section and to

    His essay is really is a reminder of how ridiculous it all was. So sloppy, such a mess, he calls it a "dumpster fire", it was really like a slap in the face of the American people, much less everyone involved in the health care system, as if they were stupid or something. It still boggles the mind, the only suggestion he has as to the "why?" is that Ryan may have intended the Senate to change the whole damn thing.

    This piece frames the failure in historical terms:

    Movements long ensconced and habituated to power — such that when their leaders are out of office, their ideas still dominate — get out of that practice. They lose touch with that external reality of their opponents. The impulsion outward disappears; they grow isolated and doctrinaire, more sectarian than evangelical. Arguments their predecessors had to sweat their way through soften into lazy nostrums or harden into rigid dogmas.

    How does that relate to nostrums on the left? Is now really the time to turn around and push for Medicare-for-all, or will it simply highlight how powerless and unprepared for that fight *we on the left* are as well? Your quote seems to fit those who don't have to fear winning elections as well.

    What I saw bouncing around all the Sunday TV news shows and the main political sites:

    an awful lot of spin, conspicuous, along the lines of "let's start over, do it right, reach out to the Democrats and work with them, because our people need some reform".

    Including a particularly impassioned interview with Gov. Kasich on CNN, going to D.C. next week....

    I have no clue who is behind this, but I will say that in all of it, I sensed this meme: let's fuggeaboutit those Freedom Caucus freaks, we're going nowhere with them.

    Just sayin'

    New Trump tweet on topic:


    Democrats are smiling in D.C. that the Freedom Caucus, with the help of Club For Growth and Heritage, have saved Planned Parenthood & Ocare!

    — Donald J. Trump (@realDonaldTrump) March 26, 2017

    & also

    Freedom Caucus Loses Member Amid Trump Criticism for Health Care

    Excellent link. One thing it makes clear, as if we didn't know it already: ideological purity and making sausage are in direct opposition.

    Next up: NO WALL

    (But of course, if Mexico would pre-pay, they'd no doubt go along. cheeky)

    Obamacare isn’t shrinking. It’s actually expanding.

    Updated by Sarah Kliff @, Mar 29, 2017, 5:40pm EDT

    This is not a joke! My favorite news publications right now are the Kansas City Star and the Lawrence Journal-World. Both are covering the twists and turns of the state's Medicaid expansion battle. That, and not the Washington debate over Obamacare repeal, is the key health policy fight to watch right now.

    Republican efforts on Obamacare repeal are stalled. There is no plan that can get enough support to move through Congress. Chris Jacobs, writing at the Federalist, has an especially good synopsis of why this problem seems intractable. He writes that there are "fundamental disagreements within the Republican party and the conservative movement about Obamacare." Namely:[....]

    Trump was right about health care for most of his life

    By Fareed Zakaria, op-ed @ Washington Post, March 20

    [....] Trump has now taken up the call to repeal Obamacare. But until recently, health care was actually one of the rare issues on which he had spoken out, before his campaign, with remarkable consistency. In his 2000 book “The America We Deserve,” he wrote:

    “I’m a conservative on most issues but a liberal on this one. We should not hear so many stories of families ruined by healthcare expenses. . . . We must have universal healthcare. . . . The Canadian plan . . . helps Canadians live longer and healthier than Americans. There are fewer medical lawsuits, less loss of labor to sickness, and lower costs to companies paying for the medical care of their employees. . . . We need, as a nation, to reexamine the single-payer plan, as many individual states are doing.”

    Trump was right on this issue for much of his life. He has now caved to special interests and an ideology unmoored by facts. He could simply return to his convictions, reach out to Democrats and help the United States solve its health-care crisis.

    And also March 30 @ WaPo, ashocking op-ed coming from: Charles Krauthammer (!!!) where he envisions a Sept. revival of a GOP plan, and after that...maybe single payer, supported by Trump (!!!)

    The Road to Single-payer Health Care

    [....] Acceptance of its major premise — that no one be denied health care — is more widespread than ever. Even House Speaker Paul Ryan avers that “our goal is to give every American access to quality, affordable health care,” making universality an essential premise of his own reform. And look at how sensitive and defensive Republicans have been about the possibility of people losing coverage in any Obamacare repeal.

    A broad national consensus is developing that health care is indeed a right. This is historically new. And it carries immense implications for the future. It suggests that we may be heading inexorably to a government-run, single-payer system. It’s what Barack Obama once admitted he would have preferred but didn’t think the country was ready for. It may be ready now.

    As Obamacare continues to unravel, it won’t take much for Democrats to abandon that Rube Goldberg wreckage and go for the simplicity and the universality of Medicare-for-all. Republicans will have one last chance to try to persuade the country to remain with a market-based system, preferably one encompassing all the provisions that, for procedural reasons, had been left out of their latest proposal.

    Don’t be surprised, however, if, in the end, single-payer wins out. Indeed, I wouldn’t be terribly surprised if Donald Trump, reading the zeitgeist, pulls the greatest 180 since Disraeli “dished the Whigs” in 1867 (by radically expanding the franchise) and joins the single-payer side.

    Single payer definitely got a lot of buzz today, almost spooky:

    New York State Inches Closer To Single-Payer Plan With Pickup Of New Support

    But critics wonder whether the additional backing is merely symbolic.


    The push to implement a “Medicare for all”-type system in New York state just took a significant step forward Wednesday. Sen. Jeffrey Klein, who heads the Independent Democratic Conference in the state Senate, plans to co-sponsor the measure, and will bring along the remaining holdout in his caucus, his spokeswoman Candice Giove told The Huffington Post.

    That gives the measure the unanimous support of the IDC, a crucial, and often recalcitrant, bloc of lawmakers. “All members of the independent conference will become cosponsors of that bill,” Giove said [....]


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