Rube Goldberg. Now with more rubes.
by Tom Sullivan
Jimmy Kimmell last night, responding to criticism over his on-air criticism of the Graham-Cassidy health care bill:
There’s no way President Trump read this bill that he says is ‘great.’ He just wants to get rid of it because Obama’s name is on it. The Democrats should just rename it ‘Ivankacare.’ Guaranteed he gets on board. Can you imagine President Trump sitting down to read a health care bill? It’s like trying to imagine a dog doing your taxes. It just doesn’t compute.
I read that as “Ivancare” and the joke still works for some reason.
The Washington Examiner’s Philip Klein has his own criticisms of the Graham-Cassidy bill. It keeps too much of Obamacare’s taxing and spending in place than previous GOP plans, he complains.
But Klein argues in the New York Times that turning health care over to the states as block grants (the GOP loves them some block grants) will unleash innovation, potentially 50 different flavors of it. Ask your doctor which state is right for you.
Besides, Klein writes, some states are younger. Others are older. Some are richer. Some are poorer. Some more urban. Others more rural. Heart disease and obesity are bigger problems in Mississippi than in Colorado. Pro tip: Don’t move to Mississippi.
Klein concludes:
A more flexible system would give states latitude to pursue health care programs that are a better fit for their populations’ ideological sensibilities.
Forget all the column inches just devoted to demographic and geographic diversity. Because what’s vital when treating your child’s cancer, what’s really important in a national health care plan, is having the proper ideology.
Hey, maybe Republicans should call it “Ivancare.”
That Americans might have to pay the price for all that flexibility is less relevant to Klein than “genuine federalism in health care.”
Kimmell got it all wrong on Tuesday, Cassidy complained to reporters, “I’m sorry [Kimmel] does not understand.” Kimmell fired back:
“Oh, I get it. I don’t understand because I’m a talk-show host, right? Well then, help me out. Which part don’t I understand? Is it the part where you cut $243 billion from federal health-care assistance? Am I not understanding the part where states would be allowed to let insurance companies price you out of coverage for having pre-existing conditions? Maybe I’m not understanding the part of your bill in which federal funding disappears completely after 2026? Or maybe it was the part where the plans are no longer required to pay for essential health benefits, like maternity care or pediatric visits?”
Not to mention (as Kimmell did) the dozen-plus national health care groups opposed to the plan.
But more people would be covered under his plan than under the present system, Cassidy insisted. The Washington Post fact checker tried to find support for that statement and found it lacking:
The block grants would grow according to an index lower than general inflation — not according to how many people are covered or what diseases they have — so the total pot would grow more slowly than under current law. All funding would be terminated by 2027, unless Congress acted at the time to continue it.
But of course with no time for the CBO to score the bill before the September 30 deadline for passing it with a simple GOP majority, it is hard to know how more people would get coverage with less money. And “innovation” is just vaporware.
Spokesman Ty Bofferding said the United States spends more than twice as much per person than countries in Western Europe – all of which have universal health-care systems – so it was reasonable to believe better outcomes were possible with fewer dollars.
Trust us. Those other countries use economies of scale, uniformity and predictability to keep down their costs. Surely, 50 different for-profit systems could be just as frugal, right?
Rather than improving on Obamacare, what Republicans are offering is to replace our private insurance-based system with something even more Rube Goldberg.
Now with more rubes.
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