How politicians take people's healthcare: a playbook

[mjkuhns]

It appears that the American Health Care Act, sometimes called "Trumpcare," is lining up support in the United States Senate.

This seems remarkable, given that the bill is absolutely reviled by Americans. For that matter, its tiny margin of approval in the House of Representatives was generally credited to reps voting yes but counting on the Senate to reject the bill. Right afterward, many senators wrinkled their noses and said they would be starting over from scratch.

Yet all indications are that the Senate has focused on passing essentially the same, reviled AHCA.The one which is forecast to leave 23 million more Americans without health coverage than doing nothing at all.

How can politicians convince themselves to do something like this, even after making public statements that they would not? It seems to me that the process follows this general outline:

The playbook for taking healthcare away from people

1. Persuade each other that the status quo is imploding. Say this, a lot, but also:

• Actively undermine an existing program.
• Drive participants away by sustaining massive uncertainty around what you're going to do.

2. Narrow discussion to a choice between your plan and collapse.

• Insist over and over that either your plan is passed, or else we'll be left with nothing.
• Firmly refuse to allow any alternative proposals into the discussion.

3. Keep it secret.

• Negotiate all of the details behind closed doors.
• Avoid confrontation with the public wherever possible.
• Avoid complete, independent analysis of your plan as long as possible.
• Attack the press if they push you with questions. (Physical assault optional, but permitted.)

4. Reassure people that everyone will be taken care of.

5. Ignore general signs of negative public opinion.

6. Go after more pointed threats to your narrative, aggressively.

• Accuse anyone who complains of offering no constructive input. (Deny that you're doing step 2.)
• Deprecate any qualified professional analysis which does issue.
• Spend whatever it takes to buy elections which take place while you're lining up the votes.

7. Steadily convert internal doubters:

• apply peer pressure
• promote a siege mentality
• distribute favors and promises, obviously
• also keep back-and-forth going long enough so that eventually, everyone can salve their consciences with the belief that "I helped make it somewhat better"
• focus on moving forward, and the promise that if everyone finally votes yes and gets it over with, they can move on.

8. Count on people forgetting by the next election.

…
Can the playbook be defeated? I don't know. I intend to do all that I can over the next few weeks to defeat steps 1-7. (As a freelancer with a preexisting condition, my own future is on the line, just like millions of others'.) If you want to join in, here are good places to start.

That said, officeholders are broadly empowered to ignore citizen disapproval when they choose to do so. If they do, then step 8 is always the crucial test. We'll see.

[Tim Liston]

The whole Obamacare vs. Trumpcare debate (which began with Hillarycare?) is nothing but a distraction. It's the Rep/Dem duopoly distraction from the important debate, which is how to drive down medical care costs organically. How to make medical treatment actually cost less. The Whoevercare debate is nothing but a squirrel, as in "look over there."

There is only one way to drive down medical costs in this country. Unfortunately, not a lot of people want to hear it. So they cover their ears and go LA-la-LA-la-LA and hope like hell nothing changes. The Whoevercare debate is about how to apply lipstick to the pig.