Rich Lowry thinks not even the God-King knows what ‘Trumpism’ is, plus other stuff…. (More)
“No officeholder in Washington seems to understand President Donald Trump’s populism … including the president himself”
Trumpism is in crisis.
This isn’t a function of poll numbers, or the Russia controversy, or any other melodrama of the past three months, but something more fundamental: No officeholder in Washington seems to understand President Donald Trump’s populism or have a cogent theory of how to effect it in practice, including the president himself.
Lowry opines that the GOP’s Wealthcare Act failed spotlighted Speaker Paul Ryan as a typical small-government, pro-billionaire conservative rather than a populist. He continues:
Maybe Ryan doesn’t “get” the new political reality created by Trump’s victory, as the president’s boosters like to say. But what excuse does the president himself have for evidently not “getting” it, either?
His energies were taken up trying to placate the conservative House Freedom Caucus. The supposed affinity between Trump and the Freedom Caucus is one of the great ideological misunderstandings of our time. Just because Trump and the conservative caucus are both “anti-establishment” doesn’t mean they have anything else in common. Trump is more naturally an ally of the moderate Tuesday Group, except with a flame-throwing Twitter feed.
The range of possible outcomes of the Trump presidency is still wide. Unexpectedly, one of them is that his most die-hard populist supporters will eventually be able to say that Trumpism, like socialism, hasn’t failed, it’s just never been tried.
Or, and I’m going out on a limb because squirrels do that, maybe the ‘crisis’ is that a ‘populism’ grounded in bigotry does not offer policy guidance that would comply with the Civil Rights Act and the Fourteenth Amendment’s Equal Protection Clause.
The policy expression of ‘Trumpism’ would put white men at the head of the line for jobs, health care, and everything else, while Other People settle for whatever leftovers there might be once those Real Americans™ are satisfied. But federal courts would smack down any law that actually delivered on the God-King’s implicit (and sometimes explicit) promises of white male supremacy. No one has “a cogent theory of how to effect [Trumpism] in practice” … because its fundamental aims are contrary to our Constitution and other federal laws.
It’s not that ‘Trumpism’ has “never been tried.” It’s that we tried white male supremacy for over 150 years … and it was so awful for everyone else that we’ve spent the last century or so trying to change it.
“As soon as we figure it out and get the votes”
Asked if the GOP health bill will come up again, House Majority Leader Kevin McCarthy said, “Yes. As soon as we figure it out and get the votes.”
A Republican leadership aide said there are currently no plans to vote on any health-care legislation this week, next week or over a weekend.
But McCarthy said nothing is currently scheduled and didn’t indicate how leadership would resolve divisions between the Freedom Caucus and moderates in the so-called Tuesday Group. “Lot of people are talking,” he said.
That makes sense. When it comes to health care, talking is about all Republicans can manage.
“It probably isn’t saving many lives”
Speaking of health care, the New York Times’ Ross Douthat squatted over his keyboard and squeezed out this turd:
It’s worth raising once again the most counterintuitive and frequently scoffed-at point that conservatives have made about Obamacare:
It probably isn’t saving many lives.
One of the most powerful arguments in the litany that turned moderate Republican lawmakers to jelly was that they were voting to “make America sick again,” to effectively kill people who relied on the Affordable Care Act for drugs and surgery and treatment….So far the evidence is conspicuously missing.
Bloomberg’s Megan McArdle hawked up a similar hairball:
Last week was a wild adventure on the health-care front, as the House seemed to inch closer to passing a bill that repealed or altered significant chunks of Obamacare, before shying away at the last minute. With Democrats proudly declaring that they saved millions of Americans from the brink of disaster, it seems an appropriate time to consider the latest assessment of what Obamacare has actually done for those people.
There’s a new paper out looking at how the Affordable Care Act has transformed health-care access, and in turn, what that has done for health. The authors’ first answer probably won’t surprise you: when millions more people became insured, more got checkups and primary care doctors. But it’s not obvious that these people got any healthier. As the paper puts it: “No statistically significant effects on risky behaviors or self-assessed health emerge for the full sample.”
Other studies have found substantial effects on self-assessed health, but on the harder markers of health – like blood sugar, cholesterol and blood pressure – the famous Oregon Medicaid Study found no significant improvement when government gave people health care.
Notably absent from McArdle’s and other conservatives’ citations of that Oregon study is the fact that it found Medicaid helped people significantly in other measurable ways:
Medicaid coverage resulted in an absolute decrease in the rate of depression of 9.15 percentage points (95% CI, −16.7 to −1.60; P=0.02), representing a relative reduction of 30%.
Medicaid coverage led to an increase in the proportion of people who reported that their health was the same or better as compared with their health 1 year previously (7.84 percentage points; 95% CI, 1.45 to 14.23; P=0.02). The physical-component and mental-component scores of the health-related quality of life measure are based on different weighted combinations of the eight-question battery; each ranges from 0 to 100, with higher scores corresponding to better health-related quality of life. Medicaid coverage led to an increase of 1.95 points (95% CI, 0.03 to 3.88; P=0.05) in the average score on the mental component; the magnitude of improvement was approximately one fifth of the standard deviation of the mental-component score. We did not detect a significant difference in the quality of life related to physical health or in self-reported levels of pain or happiness.
Medicaid coverage led to a reduction in financial strain from medical costs, according to a number of self-reported measures. In particular, catastrophic expenditures, defined as out-of-pocket medical expenses exceeding 30% of income, were nearly eliminated.
So yes, people on Medicaid are no healthier than people with no insurance at all … if you ignore all the ways Medicaid made people healthier. Duh.
Mother Jones’ Kevin Drum summarizes the point well:
People in the US don’t die much before age 65, so health insurance for working-age folks has never been likely to have much effect on death rates. Below age 55, it’s even less likely: the death rate is so minuscule that it would take a miracle to invent any kind of health-related practice that had a measurable effect on life expectancy. If the crude death rate is already below 0.5 percent, there’s just no way to reduce it much more.
And yet, people like health care anyway. They like it so much that we’re collectively willing to spend vast amounts of money on it. As you’ve probably heard many dozens of times, health care is one-sixth of the economy. On average, that means we all pay about one-sixth of our income to provide health care for ourselves.
Why? At the risk of repeating the obvious, most medical care isn’t about lifespan. Before age 65, almost none of it is about lifespan. It’s about feeling better. I’m taking a very expensive chemotherapy drug that probably won’t delay my eventual death by much, but it will improve my life considerably in the meantime. Ditto for the antidepressant I take. And for the arthroscopic knee surgery I had a couple of decades ago.
The same is true for putting a leg in a cast; prescribing an asthma inhaler; replacing a hip; treating an infection; inserting an IUD; treating a hernia; removing a cataract; prescribing a statin; or a hundred other medical procedures. Only a small percentage of what doctors do is lifesaving.
In short, the claim that Obamacare “doesn’t save lives” is … bullshit.
“The days of ‘trust-me’ science are over”
And speaking of bullshit:
The House voted Wednesday to restrict the kind of scientific studies and data that the Environmental Protection Agency (EPA) can use to justify new regulations.
The Honest and Open New EPA Science Treatment Act, or HONEST Act, passed 228-194. It would prohibit the EPA from writing any regulation that uses science that is not publicly available.
“This legislation ensures that sound science is the basis for EPA decisions and regulatory actions,” Rep. Lamar Smith (R-Texas), chairman of the Science Committee, said on the House floor Wednesday.
“The days of ‘trust-me’ science are over. In our modern information age, federal regulations should be based only on data that is available for every American to see and that can be subjected to independent review,” he said. “That’s called the scientific method.”
I guess we shouldn’t trust a Christian Scientist to know much about “the scientific method.” These are, after all, people who believe illness is caused by “mental error” and should be cured by prayer, and that reality is “spiritual” and the material world is “an illusion.” That may be why Rep. Smith wanted to make scientists pledge fealty to “the national interest”:
Some of his interventions seem to misunderstand the very nature of science. Last year, for example, Smith introduced legislation requiring that all scientists applying for federal grants guarantee, in a special section of their grant applications, that their work is in “the national interest.” It’s hard to know exactly what Smith means by this, but whatever it means it sets a dangerous precedent, because fundamental research should be driven by curiosity – by the simple desire to generate new knowledge – rather than by anyone’s political agenda. The real national interest is always served by the generation of new knowledge; Smith seems to think that only some knowledge is appropriate.
So no, “the scientific method” is not about using only “data that is available for every American to see and that can be subjected to independent review.” A whole lot of science involves personal data such as test subjects’ medical files. Forcing scientists to publish that – the HONEST Act would prohibit redaction of personal data – will make it harder for researchers to find participants.
Moreover, most scientific studies are published in peer-reviewed journals, and most peer-reviewed journals require you to subscribe or buy a copy of an article to read it in full. There are sound arguments for encouraging more journals to offer articles free of charge. But there’s no sound argument for requiring the EPA to use only journals that are free.
Finally, most scientific studies involve data and analysis that only other scientists in that field are competent to evaluate. The real problem with Republicans demand for “transparency” in science is that the language and methodology of most real science is not “transparent” to laypeople. If the test of ‘real science’ is whether Rusty Buttcrack of East Spittoon can read the article and crunch the numbers himself … without any technical training in that field … then we’ve gutted the idea of science itself.
And that’s pretty much what Rep. Smith and House Republicans voted to do.
Photo Credit: Associated Press
Good day and good nuts