There are 3 kinds of lies about Healthcare

Mark Twain once said that "There are three kinds of lies: Lies, Damn Lies, and Statistics." And in the case of Obamacare, Trumpcare and the Healthcare debate, all three kinds of lies are in play.

When the Affordable Care Act was enacted, it had no support from the GOP, even though the design came out of a GOP think tank. The GOP was so focused on making Obama a one term president, that it became an extremely polarized opposition to anything supported by Obama. And this included the beginnings of a national health care system based on free market principles, yet tempered by the realities of unequal wealth distribution and unequal health across subgroups of our nation's population.

I was surprised to find that a president and party would have spent so much political capital oh health care. And in retrospect, I am reminded of LBJ who noted that by standing up for civil rights, he was giving the "Old South" to the GOP. It seems like healthcare reform may symbolize something similar for Democrats, as the GOP has used Obamacare as a tool to rally the base.

Over the past few years, the Democratic party has been losing seats in both the House and the Senate. In 2016, the Democrats finally lost the presidency, which gave the GOP a chance to remake healthcare in ways that may reflect either an ideological purity or a pragmatic recognition of reality. Unfortunately, the first important draft at a reform bill will only serve to double the number of uninsured people, and give excessive tax cuts to the rich.

Designing reforms to a health insurance system is not something that can be done in days. It took the Democrats months to flesh out a plan, and then they had to pull out all stops (including bringing in a sickly Ted Kennedy to help break a filibuster) to get the bill passed. Even then, the bill was far from perfect - and was signed into law with known problems. The Obama administration figured that Healthcare reform was now in play, but repeal would be political suicide once the average citizen started to receive the benefits of this new entitlement.

President Trump promised that he would sign a repeal of Obamacare the day he took office. It's been roughly two months since he took office, and no repeal or replacement bill has been signed into law at the time I'm writing this entry. The GOP never thought that they would be in a position to fulfill its promises to repeal Obamacare, and now they are caught between keeping this promise and doing the right thing.

The GOP is saying lies of varying magnitudes in regard to the ACA. What they are not saying is that their lack of cooperation in congress and in their statehouses helped to cause major problems in the "Red States". Obamacare is in trouble in many of the Red States, as quite a few did not accept federal monies for Medicaid expansion.  As a result, many people who could have gotten medical care were caught in a gap - between Medicaid eligibility and being able to afford healthcare. So they got screwed by their own leaders, just because of a political game that was being played.

In the "Blue States", we see a system that is relatively successful. Yes, there are problems. But people are accessing healthcare who could never have afforded it in the past. So, what's going to happen to them now that the GOP is in charge? Trump and the rest of the GOP do not want to look at the statistics regarding Obamacare. The Congressional Budget Office did predict a $370+ million savings due to the GOP's most recent health care reform bill. But it said that the number of uninsured would more than double. This means that the GOP will need to tell big lies to mollify its base - a base which is finally coming to terms with the Affordable Care Act, not realizing that it is one and the same as the dreaded "Obamacare".

There are Senators warning GOP house members that the current bill will be DOA if it reaches the Senate. Both the President and the Speaker of the House are saying that this bill is the only one that might pass muster in the House. Yet something more may be going on here.  Could a bad bill be written up, making it possible for purists to say they voted for an acceptable bill that will never come to law - and please their constituents?  Could a future bill be designed to "repeal" the ACA, but merely be a set of tweaks to make the existing law more palatable?

What is most telling is that TRUMP, a man who puts his name on everything, boils red when he hears the phrase "Trumpcare". He doesn't want his name associated with a GOP suicide pact. And yet, that's what seems to be happening right now - GOP Congressmen and Senators are avoiding their constituents in order not to address their fears of losing affordable health care.  Does this mean that because of ideological concerns that the GOP may commit political suicide?  Who knows?

The other night, Bernie Sanders held a town hall in "Trump Territory". And it is amazing how he addressed the concerns of West Virginia voters better than that of their own leaders.  In fact, one person there said that he was amazed that Sanders was looking out for retired coal miners more than Mitch McConnell, a Senator from a nearby coal mining state. What does this say about our 2 party system? To me, it says that if a party ignores the concerns of people who are minorities in the party, it will lose the votes to the other party - even if the only things given are lip service and lies, as the GOP has done for years.

Even in a state that bleeds red, the ACA has shown to be useful. It made sure that coal miners suffering from Black Lung disease got the benefit of the doubt when claiming benefits - something that would be lost in an ACA repeal.  People in Trump Country see this, and do not want the ACA repealed - they want it fixed.  Even so, our VP went to Kentucky and talked about all of Obamacare's failures - even when the little guy is starting to see the benefits of the law.  I can only imagine what would happen to the GOP if more people started seeing the lies for what they are - mistaken tribal and ideological opposition to a "lesser of evils" law.

In the major Western nations, there is no country which has free market health care - not even us.  In a free market, people would die if they were taken to the hospital without money or insurance coverage. Out of humanity, we require hospitals to treat all people regardless of ability to pay, and then those hospitals shift their unreimbursed costs to those least able to pay "rack rate" for medical care. And yet, the GOP keeps arguing that a free market can work with health care when there are no examples in the world of a free market working for health care.  What lies will they tell to bamboozle their base to convince them that a return to healthcare's past is what is needed in a "reform" effort?

Luckily, there are a few GOP Congressmen and Senators willing to buck party ideology and demand that a replacement bill actually be better than the system we have now. It's not important that they dress up their verbiage in fantasy talk or pragmatic statements. Instead, it's important that they are realizing that if the GOP breaks Obamacare without having a better Trumpcare ready to roll, then the GOP could lose both houses in the next election, and possibly start losing the statehouses as well.

I predict that we will hear a lot of misinformation spouted over the next few weeks while ACA repeal is being discussed. Luckily, the Democrats still have the ability to filibuster many bills that come through the Senate, and have an effective veto that can be used for most half-assed attempts to repeal the ACA. Hopefully, the Democrats will use what little power they have left in both a wise and effective manner.  And I hope that in the middle of this political game being played, that people lose the ability to purchase healthcare that they once enjoyed under the ACA.

A seismic political shift may be underway

With the 2016 election cycle, we may be seeing a seismic change in American politics as we know it.  America saw it happen on the brink of the Civil War, when the Whig party collapsed, and the Republicans took their place.  In 1912, something similar almost happened, where the Reform (better known as "Bull Moose" party) under Teddy Roosevelt had a shot at disrupting the two party system.  And now, we had two major disruptors in the name of Trump and Sanders who almost emasculated the power of the political elites to control elections.

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Over the past 50 years or so, we've seen great cultural change.  Bill Maher commented "If you liked the 50's, you're a Republican. If you liked the 60's, you're a Democrat." In so many ways it is true - the cultural divide we have now comes from the conflict from that era. If you were a white male, the 1950's were the apex of White privilege in America. If you were a white male, you had virtually everything handed to you - as there were no challengers from other backgrounds, nor did any females pose a threat.  People of color (Blacks, Latinos, Asians) had yet to demand political inclusion, and women were expected to be at home. This started to change with the protest movements of the 1960's, and the extension of civil rights to most people upset those who formerly held all the power in our society.

During LBJ's presidency (1963-1969), the Democratic party sowed the seeds that would cause it to lose the American South as a voting bloc.  LBJ was forced to carry out JFK's promises (always meant to be hollow ones) to deliver civil rights to people of color and to women.  This did not go well in the South.  As a result, in the late 1960's / early 1970's, Richard Nixon developed a strategy to wrest the American South from the Democratic party. The "Party of Lincoln" sold its soul to gain these votes by putting every roadblock it could in the way of helping the groups LBJ helped, so urban dwellers who once voted for the GOP started to vote Democratic for the first time.  This tendency continued through the presidency of Ronald Reagan, where the South and rural areas of the country became solidly Republican, while the North and urban areas of the country became solidly Democrat.

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America became a culturally divided country from its beginning.  Rural areas of any country tend to be the most conservative in nature. In the United States, this meant that few people took chances to unionize their work forces in these areas, unless the work had become extremely dangerous (such as mine work).  For the most part, jobs were few, and people took work at whatever terms were offered by their employers.  It was only one step above slavery, save that the mill owner did not have to care for his employees once fired.  Contrast this with what happened in urban areas.  Jobs were plenty, and employees had greater bargaining power.  Unions formed both to provide better working conditions and to provide better pay. Corporate socialism evolved here, and prospered when America was the unchallenged economic power in the world.

With technological change, the globalization of world markets, and a greater concern for the environment, the old orders became threatened by pressures they could not control.  As technology eliminated many jobs, nothing was done for the displaced workers. As competitors from abroad forced American manufacturing to cut costs, many American workers lost good jobs and had nothing to fall back on. And as we slowly learned to stop polluting our local environment, we put local workers out of work as we shipped dirty businesses to places where they didn't care about their people and their land.  In short, the promises made by both business and government to the public at large were broken.  The elites didn't care what happened to the common person, as long as they stayed in power.

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The rise of Donald Trump and Bernie Sanders is an indication that the public is tired of an elite that makes promises every election cycle, and that never delivers on its promises. Trump lies in every speech that he is making, and his supporters don't give a damn.  He appeals to these voters on a more primitive level of thought.  The same might be said about Bernie Sanders, except that he is not peppering his speeches with falsehoods.  Instead, Bernie told the truth as he saw it - America hasn't been run for the benefit of "the people" for years, and made both an intellectual and emotional appeal to his base.  Bernie's supporters are young, and see that there is no way the elites can or will do anything for them.  So they gave the system a vote of no confidence by supporting Bernie.  In short, the insurgents from both extremes realized the same truth - it's time to replace the ruling elites.

Trump's nomination and Bernie's failure to be nominated pose a question that America has to answer.  Do we want to overthrow the elites and deal with the risks of the amateurs being in charge?  Or, do we want to allow them to stay in power (with a big warning) as long as they change their tune and start looking out for the people as a whole? This question gets complicated when rumors fly about Jeb Bush looking to support the Libertarian Party's candidate for the presidency.  Could the GOP establishment be looking to flee their old party, clean up its mess, and find a path to becoming a center-right party again?  If so, I see the old GOP becoming a populist party for a generation or two.  And I would also see the Libertarians becoming like the GOP of the 1950's. Could this be a harbinger of a potential three-party system?  Who knows?  But I'm looking forward to the ascendancy of the Libertarians the the collapse of the GOP.

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If the Libertarians become a political force to be reckoned with, the democrats will face attacks on two fronts - one social, and the other, economic.  In a way, this will be good for the Democratic party.  It has been around almost since the founding of the republic, and it has been good at adapting to change.  Will it adapt again?  Who knows? But all I can say is that I think we're seeing a political shift like we haven't seen in 150 years....

The more things change, the more they stay the same - in the South

Years ago, scenes such as this were common through the states that rebelled against the Union in 1861. Although Slavery was eliminated by 1865, the South created "Jim Crow" and "Separate but Equal" as tools to keep Blacks disenfranchised. Making Blacks use separate facilities (if they existed) for basic needs (such as getting a drink of ice water, as in the photo above) was a way of telling Blacks that they were valued little more than cattle on the farm. Today, these signs are long gone. Yet, the South (with other conservative states) are creating a new class of third class citizen by use of laws that discriminate against a very small number of people - Transgenders. 

It shocked America when the former George Jorgensen came back to the United States in 1951 as Christine Jorgensen. She was looked on as a form of oddity then, as there were only a handful of people who had undergone a sex change operation. Even Louis Farrakhan (in his pre-Muslim Brotherhood days) wrote a song about her - "Is she is, or is she ain't?" Yet, I can't recall anyone trying to deny her the rights to go about as a woman in society. (I can't say whether she had an amended birth certificate or other ID that identified her as female, but she was treated as such by most people she met.)

However things have changed. We now know that transgenders are at least 1/3000th of our nation's population, and maybe more. And as more and more transgenders decide to live in the gender other than that assigned at birth, we're seeing conservative elements in society attempting to bring back obstacles that are intended to let transgenders know that they are considered not worthy of having basic rights.

The author of this blog entry (Wingnuts and the political machine) notes that the bigots are attacking basic human needs, such as the right of the transgenders to go to the bathroom. Since it doesn't make sense to provide separate facilities (there is no "Separate but Equal" requirement for transgenders) for such a small population, the laws that ban transgenders from using appropriate bathrooms mean that there is no place for these people to go.

Why does the sight of a transgender person worry a certain class of conservatives so much? I think that the idea of transgenders provide a proof that the gender binary that has been indoctrinated into some people since childhood is at risk. And they would rather destroy any facts that challenge their understanding of the world.  Could you imagine what these people would feel if they were to see one permanent exhibit at NYC's Museum of Sex? The exhibit I note has examples of animals which change their sex, animals which have both male and female sex organs, and animals that do not reproduce sexually. This certainly does not agree with the biblical account of creation.

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You'll notice that I started with an issue that affects a small percentage of the population. But it gets worse from there. America is a nation of immigrants. Yet, narrow minded people are "suggesting" that people change their names when they come to America to reduce the effort that the "natives" need to expend to learn their new neighbors' names. 

Time and time again, I see postings trying to stir up hatred of Islam from some of my more conservative friends. There is legitimate fear of extremists - these friends see evidence of what happens when radical Islamists get control of countries, and they are right to be worried. But they don't see that their imposition of a fundamentalist form of Christianity is almost as bad as what they fear. Yet, they do make some good points, when they note how the imposition of fundamentalist Islam has affected several countries.

 Iran - Before and After

 Egypt - Before and After

And this problem even infects a "Christian" country when a large number of fundamentalist Muslims immigrate there.....

The Netherlands -

Before and After

What I find interesting is that Christian fundamentalists who fear change can be just as extreme as Muslim fundamentalists. Both believe in forcing others to live their way - even if it means destroying anything which challenges their world view. And in the United States, it is our South that tends to put the most social restrictions on individual liberty. 

I hope that over time, it will become impossible to hold people down using religion and god as excuses to justify mistreatment of individuals. To see this day, forward thinking people will need to gain control of the media and broadcast their messages louder and more often than the opposition. As long as backward thinking people control the messages heard by the general public, we have a great risk of moving backward - as illustrated by the above pictures of Iran, Egypt and The Netherlands.  It will mean that we protect people that we don't really understand, such as Transgenders. But by protecting small minorities first, we prevent the back sliding that would put larger groups (such as Blacks) at greater risk....

State of the Disunion

Has anyone noticed that the cultural divide in America in the 21st century isn't that much different from a map of the United States drawn at the time of the Civil War?  Most of the states drawn in blue are "liberal" states, while most of the states drawn in gray and territories drawn in brown are "conservative" states. In a previous entry, I noted that the lunatics are now in charge of the asylum. What I didn't note was how geography plays a big part in a region's cultural values.

Areas of high population density are often hotbeds of cultural diversity. One can not but have his or her values tested by being in contact with people who think differently. A typical New Yorker will have coffee at a pushcart staffed by an Iranian, eat lunch at a Kosher deli staffed with Mexican labor, and have dinner at an Italian restaurant staffed by Albanians. On another day, that same person may eat breakfast at a Greek diner staffed by Columbians, have lunch in a cafeteria staffed by native born Americans, then have dinner at a Soul Food joint before rushing off to an Irish bar....

Contrast the above to life in smaller towns in the old Confederacy. In many of these small hamlets, one might not even find one decent restaurant - and have to grab a burger at the local pub. (Charlie Daniels' "Uneasy Rider" comes to mind here.) Due to the remoteness of many of these places (think of small towns in the Rockies and in Appalachia), many people socialize with people who often are related to each other by inter-generational intermarriage. Their views often aren't challenged, as they only meet people like themselves on a regular basis. When one lives in these smaller communities, the locus of social activity is often the local church. This doesn't sound like much, but think of it as the one institution in the South that wasn't crushed after the civil war, and you'll see how dysfunctional values of 150 years ago could be preserved to the present day.

Religion, as an institution, changes much slower than society in general. This is good, when people need a connection to the eternal. It is bad when dysfunctional values are passed on from one generation to another.  Years ago, my mother made a big deal about our church changing the hymnal being used every Sunday. Imagine what it was like dealing with the issue of slavery - something which the bible permits and has rules for. If a person comes from a society that accepted slavery, and was forced to end it - it is likely that the religious institutions would be slow to follow the political mandate. It is also likely that these same institutions would help people find ways around the  political mandates (legal and illegal) - which we saw in the era from Reconstruction to the Civil Rights battles of the mid 1900's.

People in conservative areas are slow to change with the times, and there are still traces of institutional racism found across the USA - including the "Northern" states. In Nixon's "Southern Strategy", he knew what language the GOP could use to flip it from Democratic Blue to Republican Blue. And he was successful. Unfortunately, he also eliminated the mixing of conservative and liberal values in BOTH parties which helped stabilize American government. Now, we have a very conservative GOP which uses both a religious and plutocratic litmus test for its candidates - and its influence is growing in the short term, while demographics condemn it to likely failure in the long term. 

Would we have been better off if the South had left the Union? I'm not sure - it'd have been one hell of a hard border for both sides to police. Socially, I think the North would have been better off, and would have looked more like today's Canada with its higher priority on social welfare and fairness. The South, however, would have had a history similar to today's South Africa - with a period of Apartheid and ostracism from world politics, followed by a more democratic, but polarized country.  

Instead of what could have been, we have what we have now - a country fragmented along a rural/urban divide, where the more conservative elements are holding off on the needed investments in our common future. Sadly, I don't see anything changing soon....