Wednesday, March 22, 2017

Democrats misunderstand Republicans.

Repeal and Replace Obamacare: Bad for Hospitals


Democrats misunderstand the political needs of Republicans.   Democrats in the Senate and citizens at the rallies and Town Halls are busy crying about the 15 million--or maybe 24 million--people who would lose coverage under Trumpcare.  Yes, Republicans care about human suffering but they understand correctly that Obamacare was wealth redistribution and richer people were giving benefits to poorer people.   The ideological values of Republicans--patriotism, work ethic, self-reliance, distrust of government, skepticism of benefits to the undeserving--are all brought into play by Obamacare.

Protect the productive from freeloaders
Democrats need to get it through their heads:  a lot of people like the idea that millions of people are being kicked off the Obamacare charity wagon.   That's the point.   In their heads they are not imagining a hard working white Christian husband and wife, both of whom are good employees of employers who don't provide benefits and they are not imagining their 7 year old child with a compound fracture of the leg standing forlornly at the doorway of a hospital.    Instead, they are imagining a lazy person eager to game the system, or a criminal here in the country illegally, or a person terribly improvident in his life choices hoping an indulgent country will save him from his own stupidity.   They are the undeserving poor.

Senators and rally-goers run the risk of assisting Republicans.   Defense of the poor is understood to be the indulgent mommy taking money from hardworking Americans to assist the feckless and the criminal.  It makes Republican office holders feel righteous.  It allows them to play to their political base.  It feeds the notion that the world is divided between workers and freeloaders.  Mitt Romney spoke of them: the 47%.  Speaking of cuts to Meals on Wheels Budget Director Mulvaney said "When you start looking at places that we reduce spending one of the questions we asked was can we really continue to ask a coal miner in West Virginia or a single mom in Detroit to pay for these programs?  The answer was no."

Republicans have compassion, but they focus their attention of different people than do Democrats.

Democrats need to refocus their attack on Trumpcare.   An article in Breitbart--the semi-official internet news outlet for Trump--reveals this point of mutual interest between Republicans and Democrats.   The Buffalo Buyout refers to a special deal Trump was offering to protect the Republican areas of New York State from making transfers of money into the Democratic New York City, an effort to round up votes to get to a majority to pass the bill.   

From Breitbart, emphasis added:

"House leadership may have thought it was doing a clever thing helping out non-New York City areas of the Empire State, that tend to be Republican. But, they forgot that Rep. Dan Donovan (R.-NY) represents one of the most Republican districts in the country, Staten Island, which is one of the five boroughs of New York City. Although, Donovan was leaning towards voting for the bill, he is now firmly undecided.
The former district attorney said four hospitals in his district would suffer severely under the new rules the speaker’s team designed to win over the upstate New Yorkers.       Full Article
Bi-partisan concern
Hospitals are an intersection of the interests of Democrats and Republicans because everyone can identify with being sick.  Democrats and Republicans go there and Democrats and Republicans make charitable gifts to them.  They are a public good.
Obamacare, in providing expanded Medicaid and insuring more people, reduced significantly the amount of uncollectible charity work done by hospitals.  The former system transferred money invisibly from employees and employers with private health insurance who overpaid in order to attempt to make up the losses racked up by the uninsured.   Trumpcare, in reducing the number of taxpayer subsidized patients throws the burden back onto private insurers and hospitals.

The best sign for rally-goers to carry would be "Save Our Hospitals."  

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