There are few things so exhausting as debating healthcare in the United States, where we claw each other’s eyes to achieve concessions the citizens of any other developed nation already consider a birthright. Most of the reason it’s so terrible is that it’s been conducted almost entirely within a faulty framework — how do we keep private insurers in business? Within those boundaries, there are winners and there are losers, but the essential problem still remains. Which allows the debate to fall into the usual pattern of Democrats making a schoolmarmish argument about paying more to protect the less fortunate, and the Republicans making schooldadish argument about why they’re not paying for your new shoes just so you can go out and ruin them again.
Obamacare merely patched a few of the more egregious holes in a leaking ship, and the GOP’s feel-good replacement plan largely corrects that by ripping off the patches and having a rum party on the deck. Speaking less metaphorically, the AHCA (can we just call it Trumpcare or Ryancare?) seeks to remove the individual mandate (which made people pay a penalty for not having insurance) while supposedly keeping the protections on not being thrown off your insurance for pre-existing conditions (unless your state decided to take the option to chuck those protections). No one really liked the individual mandate; it was meant as a concession to help pay for the other protections. The replacement plan also shifts the Medicare burden to the states (presumably to diffuse the blame), and defunds Planned Parenthood for a year as an added gift to… well… people who simultaneously hate abortion and preventing unwanted pregnancies. Gotta make sure those folks are happy.
Essentially, they’re shuffling around the same money so that the costs are borne by different groups. Which is only a logical solution in the sense that politics and advertising both work in basically the same way — by dividing people into groups and then targeting the message to each one. Politicians can keep fighting over who has to sit where inside the leaky ship without actually fixing it. The AHCA vs Obamacare mostly boils down to “My constituents shouldn’t be the ones getting dripped on!”
Another part of the problem is that much of the current debate seems to be based on the idea that better care will cost more. I hate to use Tomi Lahren as a frame for discussion, but she can be a useful divining rod for finding the nipple on the idiot bell curve, pandering as hard as she does to the perceived right wing middle:
I’ve heard variations of this same argument in every healthcare debate, the old “I don’t want to pay for someone else’s healthcare” argument to which Tomi adds a nonsensical Constitutional frame for added meme-ability, she really knows her audience.
This would be a straw man if only it weren’t so common. There are many reasons it’s a terrible argument, but first and foremost…