Jun. 30th, 2017

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By now you know the GOP House finally came up with a bill to replace Obamacare, and everyone freaked out over it. Then the Senate came up with its own version, and now everyone is freaking out about that.

I’m hesitant to even post anything about it because Holy Cats, no one wants to have a rational conversation about healthcare in America. No one is interested in facts. I know this because even the fact-checkers are taking a beating from people on both sides for trying to put the AHCA and the BRCA in perspective. No one wants perspective – if yr not describing either bill as either the biggest most evil disaster ever or the end to the national nightmare known as Obamacare, FAKE NEWS!

Also, I’m not an expert on healthcare, and I generally don’t like to comment on things I don’t know that much about. But I do know a little about Congress and bills (thank you, Schoolhouse Rock), and I know a bit more about political grandstanding. So I do have a few thoughts on those.

1. Both the AHCA and BCRA are pretty clear evidence that the GOP has basically lost its collective shit over Obamacare to the point that they don’t really care what they replace it with, so long as it’s replaced. Secret drafts, fast votes, no CBO vetting – “There’s yr stupid bill, now vote! Don’t read it, YR WASTING TIME!”

I’m exaggerating, of course. But not by much. And it speaks volumes when yr party leadership is so eager to pass a bill that they don’t even care that they literally have no idea if it will work as promised or even improve the healthcare situation.

2. However, the more I think about it, the more this approach makes sense – especially now that we know the details of the BCRA/AHCA bills and their projected impact. It doesn’t matter if they’ll improve the healthcare system because they’re not designed to improve the healthcare system or make it affordable – they're designed to dump Obamacare, slash Medicaid, cut taxes on the wealthy and leave as much as possible to the free market. Any possible benefit to healthcare costs is incidental.

That’s not too surprising to me, because the GOP never really wanted federal healthcare reform in the first place, unless by “reform” you meant “dumping Medicaid altogether”. It wasn’t until Obama made healthcare a major issue in his 2008 campaign that they sort of felt compelled to come up with a serious alternative plan. Meanwhile, the GOP has always wanted to ditch Medicaid and other federal entitlement programs for strictly ideological reasons (welfare state, givers and takers, austerity, etc). The only reason they haven’t gutted it already – not even in the 90s when they took control of Congress and in the early 2000s when they controlled all of Congress AND the White House – is because entitlement programs are so entrenched that voters get very angry when you try to take them away. Repubs always talked a big game but in the end, no one had the political nerve to touch Medicaid.

3. The fact that they’re doing it now suggests that either the political tide has turned in their favor, or Mitch McConnell and Paul Ryan think it has, whether because of Trump or gerrymandering or they spend too much time watching Fox News or whatever. There’s the small matter that the BCRA/AHCA bills are massively unpopular in the polls – and the CBO score won’t fix that – but, you know, fake news? Or it’s not Obamacare and that’s really the important thing, right?

Or maybe McConnell knows full well that he’s taking a major political risk with BCRA but has decided, the hell with it, this is the best chance we’re going to get and it will not get this good again. It might also be that he intentionally put the worst, most extreme bill possible out there to make the subsequent compromise look like a good deal.

Or maybe it really is mass psychosis fuelled by insane visceral and irrational hatred of all things Obama, encouraged by Trump’s apparent mission to literally undo and erase every single thing that Obama ever did in office – especially his signature accomplishment.

Honestly, I don’t know what McConnell and Ryan are thinking. But I can say with certainty that the GOP would not be writing these cockamamie bills if they believed there was any serious risk of losing power.

4. One thing I’m pretty sure they are NOT thinking is, “Ha ha ha, this bill will kill millions of poor people!” Many critics on the Left would have me believe otherwise. Sorry, no. I’m sure that’s easy to believe when you’ve already bought the meme that the GOP are literally one-dimensional evil Nazis. But I don’t think it’s true.

That doesn’t mean the bills won’t result in people losing insurance they currently have and potentially dying as a result of being unable to afford either healthcare or insurance. But it doesn’t mean the GOP intentionally wrote the bills to specifically ensure that poor people will die – which is clearly what those memes are meant to imply. Like I said, the bills aren’t really about healthcare at all. GOP legislators have their eyes on the prize of ditching Obamacare and implementing ideological austerity measures (tax and entitlement cuts) in its place. That’s it.

The worst you can say is they don’t care about negative impacts like people losing healthcare and dying. And even then, they’ll just trot out the old “personal responsibility” meme (which sounds more noble than “every crumb for himself”). Or, if yr a Fox News contributor, you can deploy the old “c’mon, we all die someday” line (in which case let's just close all the hospitals, because why bother getting well when yr just gonna die eventually?).

That said, it’s kind of funny to see Repubs complain about liberals talking up that angle when the GOP and the Tea Party ran so hard with the “death panels” meme back when Obamacare was being crafted.

5. Anyway, we’ll see where this goes. The Senate vote has been delayed – undoubtedly to give McConnell some breathing room to put his vote-whipping skills to good use. And we may see some amendments to the current draft, although it’s possible they could make the bills even worse (like Mitch’s recent addition that if you don't buy the insurance you can no longer afford thanks to this bill, we get to penalize you for that).

But as far as I can tell, the BCRA and the AHCA are two sides of a terrible and stupid coin that create more problems than they solve.

6. But again, I don’t know much about healthcare, so I could be wrong.

7. In the interest of fairness (which no one cares about, but hey, whose blog is this?), here’s an interesting interview with conservative health care expert Avik Roy who is very much in love with the BCRA and explains why it’s a good idea. Basically, it comes down to whether the healthcare markets work the way pro-ACA people think or the pro-BCRA people think.

I’m not saying he’s right or wrong (and I do think he’s wrong on things like dismissing the polls) – and many of his fellow conservative wonks don't agree with him (mostly because they think it's just another version of Obamacare and not the full-on repeal they wanted) – but it’s a far better-worded defense of BCRA than any of the Senators or Fox News creatures actively pushing it.

It’s certainly better than the one I usually hear, which is usually “Obamacare is a disaster!”, followed by the explanation that the “disaster” is that it personally inconveniences them in some way – which is kind of the same as saying, “I don’t care how many people it helps – it’s not helping me, so I say we dump it entirely!”, which kind of makes them sound dickish.

I’m just saying.

Call the doctor,

This is dF
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And etc and so on and things of that nature generally.

Amusing Ourselves to Death: Public Discourse in the Age of Show BusinessAmusing Ourselves to Death: Public Discourse in the Age of Show Business by Neil Postman

My rating: 4 of 5 stars

This is the classic book by Neil Postman about the negative impact of television replacing print as the primary medium of public discourse, framed on the hook that Aldous Huxley’s Brave New World was a more accurate prophecy of future Western dystopia than George Orwell’s 1984 – that is, the biggest threat to autonomy and free thought isn't totalitarian strongarm govt suppression, but enabling endless amusement that encourages us not to think at all. It’s not the usual anti-TV tirade some people might expect – Postman’s target isn’t “junk” TV shows but “serious” shows that claim to be informative, intellectual and educational but aren’t – nor can they be, because the medium of television simply isn't designed for it. TV transforms news, education, religion and elections into dumbed down entertainment that converts knowledge into non-contextual useless trivia.

Naturally it’s tricky to read this with 30+ years of hindsight since its publication in 1985, not least since on-demand TV, the internet, smartphones and social media have changed how people watch and interact with TV. Even discounting that, Postman sometimes overstates his case a little, and some of his examples don’t quite work for me – particularly his criticism of Sesame Street. And yet, overall, when you look at the multimedia landscape today, he wasn’t wrong in terms of entertainment value rather than substance becoming the chief prerequisite of TV news, religion and election campaigns. One wonders what he would make of blogs, Twitter, and “tl;dr”. Anyway, I’d recommend this to anyone who wants to understand what we sacrificed when we embraced television as a cultural centerpiece. Even if it doesn’t answer all yr questions, it’s a great conversation-starter. (Also recommended: How to Watch TV News)


After Things Fell ApartAfter Things Fell Apart by Ron Goulart

My rating: 3 of 5 stars

This is another Ron Goulart novel that I read maybe 30 years ago and decided to re-read, and it’s one of his more acclaimed novels. The setting is a fragmented future America which, following a failed invasion by China, has devolved into packs of subcultures fighting for dominance – at least in California where the story takes place. This being Goulart, though, all of that is just a comic backdrop for a detective story in which Private Inquiry Office agent Jack Haley searches for Lady Day, a militant feminist outfit killing prominent officials in broad daylight. This book may be difficult for many people to like. It’s not serious, realistic speculative fiction, but rather the kind of oddball bare-bones 2D comic-book adventure that Goulart typically writes. Also, the story’s inclusion of casual racism, sexism and homophobia is going to put some people off, though it may help to know the book was published in 1970 when all three were prominent at a time when minorities, women and LGBTs were fighting for their civil liberties – Goulart’s America is a reflection of the social tensions at the time. Anyway, it’s a little different from Goulart’s usual stories in terms of setting, but otherwise for me it’s a typical Goulart romp – lightweight, but entertainingly madcap.


The Stainless Steel Rat Saves the WorldThe Stainless Steel Rat Saves the World by Harry Harrison

My rating: 2 of 5 stars

I’ve been aware of the Stainless Steel Rat series for a long time, but I was never really motivated to try it. My motivation for trying this one was driven partly by it being a cheap used copy, and partly by recently reading and liking Make Room! Make Room!. This is the third installment of the life and times of Slippery Jim diGriz, a master thief in the far-flung future who is recruited by Special Corps, an intergalactic law enforcement agency that recruits criminals like him. In this episode, someone has gone back in time to erase the Special Corps from existence, and diGriz must go back 32,000 years to the planet Dirt (or Earth, or something) circa 1975 to stop them. The story is textbook romp as diGriz adapts to mid-70s Earth society, hunts down the culprits, and encounters one obstacle after another as his plans don’t exactly pan out. It sounds like fun, and it’s meant to be, but I confess I didn't get much out of it. The time travel bits are clunky, the villain speaks comic-book dialogue, and diGriz himself is a bit too flip about the whole thing – or maybe not flip enough. I realize none of this is meant to be taken seriously, but I just felt Harrison wasn’t having as much fun with this as he could be – or at least not as much fun as I’d hoped. Which is my problem, of course, not his. And I don’t know how it compares to other books in the series – maybe this wasn’t a good one to start out with. I’d like to try more Harrison, but I’ll skip the other SSR books for now.


Invisible ManInvisible Man by Ralph Ellison

My rating: 5 of 5 stars

I remember wanting to read this in high school – until I realized it wasn’t about the Invisible Man from the horror movies, after which I lost interest. It might be as well, since – like a lot of classic lit – I probably wouldn’t have appreciated this at the time. But I can appreciate it now. The narrator of the story is invisible in the social sense, in that people refuse to see not only his reality as an African-American, but the reality of all African-Americans. From his early youth in the racist South to his college years and his migration to New York City where he becomes the Harlem spokesperson of “The Brotherhood” – a left-wing activist group promoting sociopolitical change (basically Marxists all in but name) – the nameless narrator deals with the issue of identity (personal, racial and political) as his illusions and expectations are shattered one by one. It’s a very intense book with a sympathetic if flawed main character – you want him to succeed and it hurts when he doesn’t. It's also absurdly funny at times. What’s really striking about reading this for the first time in a post-Ferguson world is that the Ferguson story is nothing new. It’s very old, and there are still people who refuse to even acknowledge this reality – as if the Mike Browns of the world are still invisible to them. Which makes this novel as relevant today as it was when it was first published in 1952. Essential reading.

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