Center for American Greatness • Congress • Democrats • Obamacare • Post • The Left

There is No Such Thing as Free Lunch (Nor Free Healthcare)

Americans are really beginning to sour on Obamacare, misleadingly titled the Affordable Care Act. Every year premiums go up, out of pocket costs go up, and care is only marginally better and in some cases worse, due to the influx of the sickest people into the healthcare system seeking generous, subsidized insurance.

Obamacare hasn’t delivered, even on its own terms. The most productive and enterprising Americans—small business owners and independent contractors—must foot monthly premiums of $1,000 or more in order to have the privilege of shelling out even more thousands in the event they get seriously ill.

In light of this debacle, some have resorted to magical thinking. Our favorite magician, young congresswoman-elect Alexandria Ocasio-Cortez (D-N.Y.), tweeted the following in favor of “Medicare for All”:

While conservatives have generally rejected solutions like this, the impulse that drives the desire is understandable. Medical inflation is enormous and grossly disproportionate to improved outcomes. Medicare is a generous and expensive program, but one that mostly serves its clients well. The elderly, who often need substantial medical care, are generally able to partake with minimal personal expense.

Medicare costs incurred by patients are certainly a fraction of what self-employed, the young, and others pay for healthcare. And medicare remains more or less solvent because lots of healthy and younger people are paying into the pool. In other words, there are multiple payers for each recipient. The same is true of Tricare, the medical insurance plan for military service members and their dependents.

These programs, however, only “work” in the sense that recipients, as well as providers, benefit greatly. At the same time, program expense has more or less doubled in the last 10 years, with these programs taking up to 25 percent of the federal budget. Programs like these could not work if they were provided to everyone, any more than an airline could survive by making the entire cabin first class while keeping prices the same. Medicare, Medicaid, and Tricare only survive because of massive infusions of outside money by nonrecipients, through deficit spending, and others forms of taxes and fees imposed on the rest of us.

Public-Private Waste
These government programs are inefficient and expensive relative to their outputs. The reason is simple: incentives. Each of these programs involves the marriage of mostly private sector profit-motivated doctors, hospitals, pharmaceutical and medical device manufacturers being paid through a seemingly blank check from the government. While conservatives, at least before Trump, were strong proponents of the private sector and free market capitalism, they never seemed to realize fully that “public private” partnerships, such as these, have the worst of both worlds. They combine the profit motives of business with the meager oversight skills of far-less-skilled and far-less-incentivized GS-12s. The payers (or rather payment managers) make a fraction of the income of those whom they oversee and have no “skin in the game” to police waste, excess, or merely the inefficient choices made by those whom they pay. Whenever these conditions prevail, we have seen similar cost spirals, such as in education and the privatization of core department of defense functions.

Obama’s critics from the Left implicitly recognized this problem, as they said Obamcare’s weakness was the lack of a “public option,” i.e., a government-provided insurance option that would create an alternative to private insurance and, in the process, a ceiling for healthcare premiums charged by private insurers and providers.

In the absence of this feature, the program really amounted to two things: an expansion of Medicaid (i.e., Medicare for the poor) and an increase of insurance rates for the healthy and the middle class in order to subsidize insurance for the poor and the unhealthy. The choice of winners and losers was deliberate, with Democrat-voting demographics (immigrants, students, welfare cases, and government workers) benefiting, while everyone else paid the bill.

As a consequence, the least productive cohorts of society would end up with top flight healthcare that cost very little to them out of pocket thanks to the Obamacare subsidies. Insurers also benefited, as they now had a larger, captive audience, obliged by law to purchase insurance. The “carrot” was mostly smoke and mirrors, including various services and benefits that payers often would not choose if they had a choice, since these costs are voidable through their own efforts, i.e., drug addiction and mental-health counseling, maternity coverage (even for single and older men) and the like.

In the end, Obamacare amounted to an expensive wealth-transfer scheme.

Why Does Everyone Get Gold-Plated Healthcare?
Republicans, in spite of years of complaining about Obamacare, lost their nerve when they had the power to do something about it.

As in any entitlement program, getting rid of it involves hard choices and would require picking some winners and losers. Thankfully, most of those most hurt by Obamacare are precisely the people already voting Republican, the struggling middle class and the employed, and any realistic devolution of the program must minimize pain to payers, preserve the good things about the existing healthcare system, and, as much as possible, restore markets for all but the dirt poor.

The start of such a plan must be a significant change: distinguishing between truly paying customers and the charity cases. Whether on Medicare, Tricare, Medicaid, private insurance, or just showing up an E.R., today everyone gets, more or less, the same “standard of care.” There is no differentiation of quality for the most part, and for reasons of liability, medical practice culture, and financial incentives, second-best—but adequate—choices are rarely deemed to be part of the solution to the medical cost spiral.

The restoration of market forces to healthcare would likely be a good thing, but it would require more comfort with a range of healthcare options, including average, good, better, and best. People show a willingness to make those choices for themselves, when given a choice. If this is not adopted now under conditions of relative plenty, it may be imposed suddenly and in draconian fashion under conditions of necessity.

While health care is different from other services (insofar as it has a pretty inelastic demand), in those areas of healthcare governed by free market principles—such as fee-for-service Lasik and cosmetic procedures—prices have gone down and quality has gone up, just as we see with electronics and other non-medical devices. Of course, even here, there are ranges of choice (with corresponding prices).

Market forces should be reintroduced for the 75 percent or so people who are paying for their own care. This would require an important change: increasing price transparency for healthcare costs through something analogous to the Truth in Lending Act. Currently prices are opaque and vary by insurer. The prices should be listed online (along with the copay depending on the insurance plan) so people can check out-of-pocket expense and shop around. The present-day regime of hidden, negotiated, and opaque pricing hinders competition massively; it’s very hard to figure out what you’re going to pay, even if you take the time to ask.

With half of every health care dollar spent by government, a tax code that encourages the provision of benefits over income, and many decades of a bias towards the most expensive types of care, we have at the moment a recipe not for bad healthcare, but rather for misallocated and very expensive healthcare—more than people would choose to pay if they were actually paying for more of it out of their own pocket.

For the government side of the house, some forced austerity is called for.

Obama originally sold his plan by saying efficiencies in record-keeping, negotiated prices, and reductions in “waste and inefficiency” would reduce overall healthcare expenditures. This turned out to be the equivalent of proposing “flying cars,” and now we have very expensive premiums, a convoluted and even more regulated system, and life expectancies going down due to the explosion of drug abuse, suicide, and other conditions arising from the general malaise of American life.

Doctors, hospitals, health plans, and government clinics should be permitted to provide minimal care with strict price limits in order to cut price and costs. We can much more cheaply deliver yesterday’s state-of-the-art, which was hardly a time of “no healthcare.” While this would be a change, if people saw real benefits in their pocketbooks, it would be palatable. A simple solution on letting this fiscal medicine go down more softly would be to provide cash rebates to providers and patients, who deliver the minimal level of services below the “par” cost.

Different Costs, Different Benefits
A range of healthcare quality and prices is not “inhumane,” but rather the norm in every other thing in life, including necessities like food, housing, clothing, education, automobiles, and neighborhoods. If we are to have “free” healthcare—i.e., healthcare for those who cannot afford their own, nor fully afford their own insurance—there is no obvious reason the charity cases need to have the best any more than they do in government-subsidized housing or food.

Part of the reason I am sanguine that a change like this is not only necessary, but also not a big problem, is that there is much evidence to suggest the outcomes would not be very different.

Expensive new drugs are often only marginally better than their predecessors, with much greater expense for payers, whether patients or otherwise. In addition, a lot of healthcare dollars are spent at the end of life, engaging in heroic efforts to add a few more pitiful and painful months of life to those who are already very sick. In any case, if people are willing to pay for it, they should be able to get it, but the choices people would make with their own dollars for their own lives are likely to be very different from those of third-party-payer model of Medicare and Medicaid. There’s no need for “death panels” when people are mostly paying for themselves. They can blow their own money, leave it to their kids as an inheritance, and make choices as best they can. For the nonpaying customers, what they get should not bankrupt the nation, as it is doing at present.

For those of working age who are totally broke or improvident, we should channel funds and provision of care to government-run and charitable clinics, but make these sources suitably unpleasant with long waits, generic drugs, and mandatory community service in case of nonpayment. This should be done not to destroy care and quality for paying customers, but in order to encourage people to get themselves work and buy their own insurance. We should end mandatory emergency room care for all but public hospitals and instead require the swift transport of uninsured patients to this regime.

As a civilized society, we should not let people die of easily treated illnesses, but we should make public care costly in other ways so that recipients know they’re on welfare and will want to get off of it quickly and so the taxpayers footing the bill are hurt as little as possible. Such a system of “C-quality care” should completely replace the current regime of doctors submitting their bills for top-of-the-line care to Medicaid.

Republicans need to think about what they’re willing to pursue, whom they will reward and what political cost they can bear, in order to stop the parasitical Medicare and Medicaid regimes from transferring even more of our national wealth to a single sector of the economy that has proven to have diminishing marginal returns. While not a perfect approach, something like this is a hell of a lot more freedom-oriented and reasonable than Obamacare.

And it’s a lot more responsible and realistic than “Medicare for all,” “single payer” or whatever snake oil is fashionable. It would preserve the high quality and freedom associated with the American system, while addressing the genuine problem of skyrocketing costs, middle class anxiety over losing coverage, opaque pricing, and the burden on the system and the public from the spread-out costs of the uninsured.

Finally, it would provide a framework for Republicans not to be merely against “Obamacare” but rather for an important principle missing from the debate: there ain’t no such thing as a free lunch.

Photo Credit: Bill Clark/CQ Roll Call

Congress • Democrats • Donald Trump • Elections • Healthcare • Immigration • Obamacare • Post • Republicans • the Presidency

Looking Forward to an Exciting Lame-Duck Session

Despite Democratic gains in the House of Representatives on Tuesday, Election Day outcomes were far from the big blue wave that liberals promised

Though Democrats managed to flip the House, the loss of at least 30 Republican seats is in line with historical averages. Generally speaking, the president’s party loses around 30 seats in a midterm year. In fact, since the start of the 19th century, only two presidents have ever avoided losing seats in the first midterm election of their presidency.

Though the media are loath to admit it, Democrats underperformed on Tuesday, and Republicans did better (far better, in some cases) than expected, limiting their House losses while gaining up to four seats in the Senate. And all this occurred in spite of these midterms being the most expensive on record, the rise of progressive superstars like Robert Francis (Beto) O’Rourke in Texas and Andrew Gillum in Florida, and a record get-out-the-vote effort by an energized liberal base.

The overall takeaway here is clear: wishing (and rioting, protesting, marching, running people out of restaurants, threatening violence, generally being indecent) doesn’t make it so. Progressive values still aren’t cutting it, particularly in red states and middle America.

But what else did we learn from these elections? Here are five key takeaways.

The House GOP is going to get more Trumpian, whether they want to or not.
House Republicans may have lost their majority, but on election night, Trump backers and conservatives did well. All eleven candidates sponsored by the House Freedom Fund—a PAC focused on electing House conservatives—ran the table, winning all their races. All these members are expected to join the conservative House Freedom Caucus, which is primed to make this already powerful negotiating faction in the House significantly more influential.

This is especially true given that the loss of many House moderates has reduced the size of the GOP conference as a whole. In a smaller GOP conference—and one without as many moderates—an expanded freedom caucus would have increased leverage, and an enhanced ability to influence policies in a conservative direction.

Moreover, freedom caucus founder Rep. Jim Jordan (R-Ohio), is campaigning for minority leader. Even if he doesn’t win against the heir-apparent, current Majority Leader Kevin McCarthy (R-Calif.), the freedom caucus will likely gain significant concessions about how the House is run in exchange for votes.

But should Jordan manage to overtake McCarthy, expect a more strategic, articulate, and positively pro-Trump agenda than we’ve seen from House Republicans in years.

Democrats are still talking about impeachment. Good luck with that.
Likely House Speaker Nancy Pelosi spent the months leading up to the election trying to tamp down talk of impeachment, calling it “not a priority” and “not a policy agenda.”

But senior members of her own party apparently have a different idea. On Wednesday, Rep. Jerrold Nadler (D-N.Y.), incoming chairman of the House Judiciary Committee, was overheard on an Acela train extensively outlining Democrat considerations for investigations and impeachment of both President Trump and Justice Brett Kavanaugh.

Pelosi may wish she could change the subject, but her progressive base wants to do anything but. A September CNN poll revealed that 79 percent of self-described liberals want President Trump impeached (according to exit polls from Tuesday’s election, just five percent of Republicans do). And if we learned anything from the total meltdown surrounding Kavanaugh’s confirmation process, these self-identified liberals are, for the Democratic Party, the tail that wags the dog.

It goes without saying that impeachment would be unsuccessful and likely end in disaster for Democrats. A successful impeachment requires the House to charge the president, and the Senate to convict him with 67 votes. While the Democratic-majority House may decide to charge the president with “high crimes and misdemeanors,” it’s highly likely the Senate will never take action.

As House Republicans learned in 1998, overreaching on impeachment in lieu of actually legislating can put you out of favor with the voters very quickly. Just ask Newt Gingrich—though the theatrics of impeachment and investigations are tempting, a robust legislative agenda is what gets you reelected.

That said, if Democrats want to pour gasoline all over themselves and light an impeachment match, far be it from me to stop them.

Congressional Republicans may want to forget about immigration, but the voters didn’t.
Though Republican leaders keep trying to tell themselves otherwise, their base does not support amnesty. And the Republicans who made a very public show of doing so earlier this year were punished for it.

Recall the amnesty discharge petition effort in June, where a group of House Republicans, led by Reps. Curtis Curbelo and Jeff Denham, attempted to force the House to vote on a bill to provide amnesty to recipients of the Deferred Action for Childhood Arrivals (DACA) program. The procedural move forced a showdown with GOP leadership, and ultimately resulted in a series of votes that went nowhere.

But Curbelo and his allies made themselves very prominent supporters of amnesty—a policy that the Republican base still does not support. And on Tuesday, seven of the 23 Republicans who aligned themselves with that effort lost their races (six of the 23 signers were retiring). The electoral losses included Curbelo, despite Paul Ryan making a special campaign trip for him. Jeff Denham, who also led the amnesty effort, squeaked by in a 50-49 race.

Though their support for amnesty was likely not the only factor that led to the defeat of those seven Republicans, it almost certainly played a role. More than half of Republican voters surveyed in June said they’d be less likely to re-elect a Republican who voted for amnesty. On Tuesday, voters told us those polls were right.

The GOP’s failure to repeal Obamacare is an ongoing issue, and helped Democrats win.
In what should be a surprise to no one, Obamacare is still a massive failure. More than 2 million people lost their coverage this year due to rising costs, and a shrinking marketplace. In states across the country, co-ops are failing and individuals buying coverage on the exchange have only one or two choices. There’s a reason health care continues to rank as a top worry for American voters.

Republicans knew that government-run health care was going to be a failure, which is why they spent eight years promising to repeal it. Except after two years with unified control of the government, they still haven’t. Rather, they’ve repealed the individual mandate. A good step, but not nearly enough to address Obamacare’s failing mechanisms or remove the stain of their culpability in permitting a health care situation that will only get worse.

It is exactly this inaction—and the failing health care system that is resulting from it—that gave Democrats their biggest talking point of the midterm cycle. “Republicans are coming for your healthcare,” they said. “If you think it’s bad now, it’s only going to get worse.”

This entire Democratic message easily could have been prevented if Republicans had just done what they spent eight years saying they would do. Repeal the law. Then reform the system.

Which leads me to my last point.

The lame duck session matters.
When the current Congress returns next week, they need to do one thing: run through the tape. November and December represent the last gasp of a unified Republican government, and what Republicans do with it matters. Whether it’s healthcare, building a wall, defunding Planned Parenthood, or passing more tax cuts, the GOP needs to unite behind specific priorities and go to the mat.

They should take a lesson from Democrats, who, on the cusp of losing their majority in 2010, shot for the moon. They went hard in on repealing don’t-ask-don’t-tell, passing the DREAM Act, and locking in higher spending. While they failed on the latter two, they succeeded in the first.

The fight matters. And lame ducks can be home to significant action if a party is determined enough to see the fight through.

Photo Credit: Bill Clark/CQ Roll Call

Center for American Greatness • Democrats • Donald Trump • Obama • Obamacare • Post • Republicans • The Left • Trump White House

Burying the Dead With Bile-Filled Histrionics

The big news last week revolved around the funerals of a 1960s pop singer and an unreliable Republican senator with a cult following among masochistic conservatives and cynical leftists eager to capitalize on his capacity to spread dissension among his nominal allies.

I suppose the exploitation of funerals for grubby political ends is nothing new. Mark Antony did it with notable success when he eulogized Julius Caesar in 44 B.C. But there was something especially stomach-churning about the injection of partisan animus into the obsequies of Aretha Franklin and John McCain.

Both were reminders—as if we needed any—of how these jangled, hyperpartisan times have the capacity to infect even the most solemn ceremonies of life with bile-filled histrionics, our latter-day version of the theater of the absurd.

The race hustling reverends Al Sharpton and Michael Eric Dyson led the bandwagon at Franklin’s funeral, loading their praise of the soul singer with vicious anti-Trump rhetoric. Dyson described the president of the United States as an “orange apparition,” a “lugubrious leech,” a “dictator” and “fascist.” Nicely done, Reverend!

The tone at John McCain’s spectacle was more restrained but the message of hatred and contempt for the president was just as patent.

The professional NeverTrumper and Twitter activist Bill Kristol sniffed that “I don’t believe the name of the current occupant of 1600 Pennsylvania Avenue was mentioned during the service for John McCain, and I’ll continue that practice, in McCain’s honor, for the rest of the day. Today was a moment to celebrate, appreciate and reflect on what is admirable.”

I’ll come back the question of “what is admirable” in a moment. But first, I think it worth pointing out how disingenuous Kristol’s tweet was. The name “Trump” may not have been publicly uttered at that orgy of self-congratulatory vituperation, but the reality of the man was palpable everywhere. Curiously, he was the star of the show in which John McCain had the title role.

The president had been asked pointedly not to attend the event. He respected the wishes of the family and stayed away. Then the media went wild reporting that he had taken himself off to the links to play golf. Instead of what, exactly? Sitting at home and watching himself be not-so-subtly abused first by Meghan McCain, then Barack Obama and George W. Bush?

“The America of John McCain,” said the senator’s daughter, “has no need to be made great again because America was always great.” Get it? Get it?

Barack Obama, in a tribute that instantiated to the letter what it pretended to abhor, lamented how “So much of our politics can seem small and mean and petty. Trafficking in bombast and insult, phony controversies and manufactured outrage. [You get a gold star for brazenness for that one, Mr. President!] It’s a politics that pretends to be brave and tough, but is instead born of fear [Oh, dear]. John called on us to be bigger than that, to be better than that.” Right.

For his part, President Bush instructed the assembled mourners that McCain “detested the abuse of power and could not abide bigots and swaggering despots.” Anyone particular in mind, sir?

One and all, they came not to praise McCain but to bury Trump.

But let us return to Bill Kristol’s invocation of “what is admirable,” that call-of-the-wild to be “bigger” and “better” that Barack Obama claims to have discerned in John McCain’s example.

Joseph Duggan, a former State Department and White House staffer in the Reagan and first Bush Administrations, offers an instructive comparison between McCain and Jeremiah Denton, the first Republican to win a direct popular election to the Senate in Alabama.

Like McCain, Denton was a war hero. He, too, had been shot down over Vietnam and endured years of torture. (It was Denton who, when paraded in front of television cameras by his captors, famously spelled out T-O-R-T-U-R-E in Morse code by blinking his eyes.)

But the contrasts between the two men were even more notable. Denton was a consistent conservative. McCain prided himself on being “bipartisan” and “a maverick.” In reality, he was an erratic and self-aggrandizing party of one. As Duggan observes, “What McCain actually did, again and again, was to sabotage consensus within his own party out of an impulse for gaining attention and increasing his negotiating position in regard to other interests.”

Is that admirable?

President Trump has made good on an astonishing number of his campaign promises, from moving our Israeli embassy to Jerusalem to enacting across-the-board tax cuts, resuscitating the American military, enforcing our immigration laws, and rolling back the smothering, counterproductive regulatory environment excreted like a sticky jelly by the administrative state.

One promise he nearly fulfilled early on was scrapping the Affordable Care Act, a.k.a. Obamacare. I say “nearly” because the president came up one vote short in his effort to rescue the American people from that ruinously expensive, state-run bureaucratic nightmare. Who was it who withheld the vote? Why, Senator Maverick McCain, of course. As Duggan put it, “With no discernible principle or regard for the public interest on his side, McCain single-handedly sabotaged the repeal of Obamacare. No one can say honestly that his motivation was anything other than spite for President Trump.”

Was that action “bigger” and “better” than those of the Voldemort that President Obama invoked without quite naming? Was it “admirable”?

There were other things that distinguished Jeremiah Denton from John McCain. When Denton died in 2014 at 89, he, like McCain, received full military honors. But as Duggan notes, “His funeral did not preempt television coverage of soap-operas, sitcoms, or sporting events. His pallbearers did not include Warren Beatty, [and] no one, obscure or famous, was told not to attend the ceremony.”

There are a few morals to be absorbed by the sorry spectacles that the funerals of Aretha Franklin and John McCain afforded.

One is the old familiar that Leftists will praise Republicans as “bipartisan” and public spirited just so long as they act and vote like leftists. At the same time, they will instantly punish any dissension in their own ranks with ostracism. Many commentators (including your humble correspondent) have indulged in the sport of contrasting the hosannahs of praise slathered on John McCain by leftists in recent months with the blistering attacks made upon him during those intermittent episodes when he supported conservative causes. At the end of his life, McCain was the enemy of their enemy, Donald Trump. Therefore, on this battlefield, he was their friend.

Another moral concerns the cacophonous tintinnabulations of the echo-chamber that has installed itself in the center of our public life. In the Nicomachean Ethics, Aristotle says that politics is the “master art,” the ultimate good at which virtuous human action aims because politics is that which orders all the subordinate activities that nurture the “good for man.” It is interesting to speculate about what Aristotle would have to say about the practice—not to say “the perversion”—of politics today. Wither phronesis (practical judgment)? What price sophrosune (moderation)?

“But, but, surely you are not suggesting that Donald Trump somehow epitomizes the political virtues Aristotle extols?”

No, I am not. At least, not exactly.

Trump is a loud and brazen personality. He has faults and flaws (unlike the rest of us, of course). Above all, he is a disruptive force. He has, in the most thoroughgoing way in my lifetime, challenged the status quo in American politics.

If you believed that the status quo was a good thing, that, fundamentally, the ship of state was sailing on in the right direction, sails trimmed correctly for the prevailing weather, with the right amount of ballast appropriately distributed—if you thought that then not only are you right to be alarmed by Donald Trump but also I have a large bridge that I would like to sell you.

Of course, many if not most political actors regularly said that the ship of state was in danger of foundering, but that was only when on the hustings. Once safely ensconced in office, they acted in ways that kept the ship lumbering along its perilous course, gunwales nearly submerged. Donald Trump, “standing athwart history, yelling Stop, when no one else is inclined to do so,” has produced a powerful counter current that may yet, might just, alter the course of the vessel in which America finds itself proceeding. It is a gigantic, lumbering barge of a ship, slow to turn, difficult to maneuver, and inertia is a such powerful thing.

Notwithstanding the president’s many successes, it is too early to say how fundamental or lasting his reforms will be.

But almost everyone by now would agree that Trump has precipitated a sharp change in the climate, the emotional and rhetorical weather, of our culture. Many commentators focus on the president’s tweets and his sometimes Tabasco obiter dicta. Doubtless those interventions can be eyebrow-raising.

What strikes me as more noteworthy, however, is the incontinent fury with which the president’s rhetoric has been met. This is where that cacophonous echo-chamber I mentioned makes its debut. One of the many ironies attending the operation of the Trump Administration is the extent to which his opponents, in their loud and adamantine opposition to the president, are guilty of the very things of which they accuse him. I know it seems odd to say, but their behavior has had the effect of making Donald Trump appear as a calming, a moderating force. Who would have thought it possible?

The anti-Trump hysteria has had a much longer run than I would have thought possible. Partly, that’s because it has been assiduously fed by a corrupt and partisan media. Partly, it is because of the self-engorging denizens of the Washington swamp—the cadres of bureaucrats, scribblers, and talking heads who have a vested interest in perpetuating and extending the swamp.

If they have been more persistent than I would have predicted, I nevertheless see them as the grasshoppers in this little fable from Edmund Burke: “Because half-a-dozen grasshoppers under a fern make the field ring with their importunate chink, whilst thousands of great cattle, reposed beneath the shadow of the British oak, chew the cud and are silent, pray do not imagine that those who make the noise are the only inhabitants of the field, that of course they are many in number, or that after all they are other than the little, shriveled, meager, hopping, though loud and troublesome, insects of the hour.”

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Photo Credit:  Jonathan Newton/The Washington Post via Getty Images

California • Congress • Democrats • Healthcare • Obamacare • Post • Progressivism • The Left

Bread and Circus Politics

The masquerade is finally over: Democrats are finally coming out as the socialists they’ve always pretended not to be. Apparently they find it freeing—I find it refreshing. Americans might finally get a clear choice moving forward between undisguised socialism and free market capitalism.

Now there are nearly a dozen Democratic gubernatorial candidates openly calling for a universal healthcare, single payer system, pounding the lectern and insisting that, by God, insurance is a human right.

But I’ll tell you what it really is: bread and circus politics.

Promise the voters anything and everything in the hope of gaining power, the consequences be damned. How one actually pays for the universal healthcare is a minor inconvenience to these socialists in the great bending arc of history. Onward to glory, comrades. Until of course the bill comes due. Loosely quoting the Iron Lady, Margaret Thatcher, socialism is great fun until you run out of other people’s money.

The sad fact here is just how fast they would spend other people’s money. The costs are staggering with universal healthcare: for a national, Medicare for all approach, it could cost up to $32.6 trillion in the first 10 years, overshadowing our already massive $20 trillion national debt.

At the state level, the costs are also sobering: California’s universal healthcare plan would cost $400 billion annually, or twice what California’s annual budget for everything is, including the newly formed Plastic Straw Stasi Division. In New York, people are being assured that yes, taxes would have to go up 156 percent, but have no fears, this will actually save money in the future. Question: have you ever in your life seen a government program that cost less or saved money? Me neither.

At the very heart of this universal healthcare plan is a falsehood that insurance somehow equals better care. That’s empirically untrue. In fact, we can see that in many places across the world, the quality of care actually goes down with universal healthcare.

Take Canada, for example. Between 1993 and 2017, the average wait to see a specialist more than doubled to from nine weeks to just over 21 weeks while the corresponding costs went up 40 percent. In England, the annual budget for the National Health Service (NHS) in 1998 was 60 billion pounds or $77,345100. In 2017 it was 124 billion pounds or $159,836,000. While costs have doubled over the last 20 years, there’s no corresponding increase in quality of life; life expectancy hasn’t gone up. Typically in universal healthcare systems you see health services more interested in efficiency, you see death panels, you see overworked nurses and doctors, and you see a lack of innovation. Do you see many people flying into England or Canada for surgeries? Didn’t think so.

Beyond the costs and the decrease in quality of care, universal healthcare would be a smash and grab policy hurting our younger generations. We would have to steal from the idealistic and sometimes, sadly, very stupid young but healthy (there are some blessings still to being a young American) to fund Americans who are their opposites in all of these respects.  When the young finally figure this out they’ll be facing a hopelessly mortgaged future exactly when many businesses will abandon their states. As in they got played for suckers. But onward, comrades, and all that.

Adding to the absurdity of it all is this concept of using the vehicles of Medicare and Medicaid for all. The socialists’ idea is to ride those two broken, corrupt, and nearly insolvent (at least with respect to Medicare) systems to socialist glory.

While it shouldn’t be a surprise that failing ideologies attach themselves to failing systems, it might surprise most people that in 2017 alone, Medicare and Medicaid combined made $141 billion in improper payments. But by all means, do tell me how glorious it would be to run $32.6 trillion into those broken systems. It’s almost as though the socialists and modern Democratic Party want to collapse our entire system of government and then offer Big Brother Government as the solution.

At some point, if Congress can’t or won’t tackle the root of the problem instead of simply throwing taxpayer dollars at broken corrupt systems like Medicare and Medicaid, it should at least do something to ease the pain of access to care—like allowing people to form associations and shop for insurance plans across state-lines anywhere in the country, potentially driving down premiums by 50 percent. There should be block grants for pharmaceuticals instead of forcing people to go through Medicare or Medicaid. People should have options to put money into savings accounts, spending their money as they see fit. Nonprofit hospitals should be compelled to have pricing and cost transparency. Let market forces go to work and I bet we’ll all be amazed at what will happen.

Photo Credit: Erik McGregor/Pacific Press/LightRocket via Getty Images

Administrative State • America • Center for American Greatness • Democrats • Foreign Policy • Healthcare • Middle East • Obama • Obamacare • Post • The Media

Obama’s Failed Legacy: Unaffordable Care and Iran’s Nukes

Ronald Reagan famously quipped that the trouble with liberals “is not that they’re ignorant. It’s just that they know so much that isn’t so.” Reagan’s words aptly describe former President Barack Obama. Obama was an intelligent, well-educated, articulate man. He could woo crowds with soaring rhetoric and pacify True Conservative™ “intellectuals,” like David Brooks (who voted for Obama partly on the basis of the perfect crease in his trousers).

Obama was not only a scion of the American political class, he was also a new kind of leader: the first black president in history and one of the youngest.

With Obama, though, we were getting an incredibly manipulative individual who bought into the most dangerous and destructive left-wing academic theories. Obama was the ultimate “intellectual-yet-idiot.” Examples of his folly are plentiful, but there are perhaps no better illustrations of the disconnect between Obama’s intellectual prowess and his practical political judgment than the disastrous Affordable Care Act and the terrible nuclear agreement with Iran. Both were highly controversial, very unpopular, deeply secretive, and painfully naïve. They were also, it turns out, extremely harmful to the American people who voted for Obama.

Obamacare Fail
Obama believes in socialized medicine, more or less. Most Americans, even many Democrats, never would have supported a scheme that was honest about aiming toward that end. So just as Obama’s healthcare policy adviser (and former architect of the failed “Romneycare” plan in Massachusetts), Jonathan Gruber argued, Obama had to lie to the American voters about what his plan actually entailed.

During the tense debate over the Affordable Care Act (ACA), Obama repeatedly told voters, “If you like your doctor, you can keep him.” That was a lie. Obama further claimed that insurance premiums wouldn’t increase. That, too, proved false. Obama and his staff then insisted that his healthcare “reform” wasn’t a tax hike. Yet when the ACA faced a challenge before the Supreme Court, administration lawyers effectively argued that the ACA was legal precisely because it qualified as a tax. Lastly, the former president claimed the healthcare exchanges established under Obamacare would be safe, efficient, and effective. Not so.

Recall how President Obama argued that he was going to stick it to the insurance companies? Instead, it’s become clear that Affordable Care Act was little more than a giveaway to them. It encouraged private insurance companies to kick the sickliest and most vulnerable off their insurance plans and then further allowed costs to escalate to such an extent that only the wealthiest Americans could afford to maintain their private insurance.

Iran Fail
In foreign policy, the Joint Comprehensive Plan of Action (JCPOA) with Iran over their nuclear weapons program was also a windfall for the Iranians. Obama’s modus operandi in selling the Iran deal was the same as that deployed on behalf of Obamacare: deception.  Obama insisted that the agreement with Iran should be hashed out in secret and refused to allow Congress to fully debate the matter. Obama claimed he was working this way in the name of peace and that he knew best about how to achieve it. In reality, Obama just wanted a piece of paper he could affix to his legacy, consequences be damned. As in the ACA deliberations, Obama’s ego combined with his wrongheaded worldview—and we’re paying the price today.

Lee Smith correctly argued that Obama entered office with an almost-obsessive urge to make a deal with the Iranians. As Smith shows, Obama’s hesitance to hit the Islamic State in Iraq and Syria was likely due to his early commitment to making a deal-at-all-costs with Tehran. It can further explain why Obama was enthusiastic about letting the Russians handle eradicating Bashar al-Assad’s chemical weapons stockpile, something no one seriously believed the Russians would—or could—do. Of course, we know that this has been proven correct in recent years, with tragic results.

Going back to 2009, it’s evident that the urge for a deal motivated Obama to ignore the mullahs’ crackdown on pro-democracy protesters marching in Tehran. I fear that it’s the reason for Obama’s precipitous withdrawal from Iraq in 2011 after we had finally stabilized the situation there.

And Obama’s determination not only to push away our traditional Sunni Arab allies but also to support the Islamists in the Arab Spring (a movement that received massive support from Iran) is best explained in the context of his obsession with getting a deal.

Thanks to Israeli intelligence, we now know for certain that Obama’s Iran deal was a total failure. As he did regarding healthcare, Obama believed in an entirely unrealistic theory. He believed that the federal government knew best how to allocate limited medical resources to the American people. In the case of Iran, Obama believed in a bizarre theory that, if the United States distanced itself from its allies in Israel as well as those in the Sunni Arab world, and allowed for Tehran to acquire nuclear weapons, then a three-sided balance-of-power paradigm would emerge. Obama was willing to deceive and manipulate the process to get what he wanted at unprecedented levels.

Obama’s behavior pushing the Affordable Care Act and the Iran deal explain why 63 million Americans voted for Donald Trump in 2016. They were tired of lies, manipulation, and failure.

Allowing Iran to acquire nuclear weapons would induce a major war, not deter one—in much the same way that handing over the health care of 306 million Americans to the federal government would exacerbate the healthcare crisis in the United States rather than remedy it.

But Obama thought he knew better.

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Photo credit: Jim Watson/AFP/Getty Images

Europe • Healthcare • Obamacare • Post • Pro-Life • Religion and Society • self-government • The Courts • The Culture • the family • The Leviathian State

Alfie Evans: From the Cradle to the Grave

Offspring was not reared at the will of the father, but was taken and carried by him to a place called Lesche, where the elders of the tribes officially examined the infant, and if it was well-built and sturdy, they ordered the father to rear it…but if it was ill-born and deformed, they sent it to the so-called Apothetae, a chasm-like place at the foot of Mount Taÿgetus, in the conviction that the life of that which nature had not well equipped at the very beginning for health and strength, was of no advantage either to itself or the state.
—Plutarch (Lycurgus: 16)

Any parent can imagine another parent’s pain. And that imagining, though merely a sliver of the real suffering, is excruciating. I can think of no worse situation than having to choose whether or not to continue treating my child.

Actually, that’s not true. There is a worse situation.

When the state takes that choice away from me and decides, contrary to my own judgment, that it’s time for my child to die. When the state won’t allow me to do everything I can to keep my child alive. When the modern state, the benevolent state, the state ostensibly built on the foundations of altruism and good intentions has decided, in all its wisdom, to kill my child.

That is exactly what happened this week when the British government decided that 2-year-old Alfie Evans had to die. That any attempt to save him would be forbidden.

Like the cruel villain who would restrain parents—forcibly keeping their eyes open while their child dies—the British justice system has decided to impose death onto Alfie Evans and ordered that no attempt be made to keep him alive. Despite not having been able to actually diagnose his illness, they pulled out his breathing tubes. But Alfie didn’t die. So death by starvation it will have to be.

Attempts to save Alfie’s life are now criminal acts.

Justice indeed.

That same “justice” is now, through the threat of violence, staying the love of Alfie’s young parents, Tom 21, and Katie 20 and yet forcing them to watch their son starve to death. It is reminding them (and anyone else who may get ideas), at every turn, of their impotence in the face of its power. The Italian government and the Vatican have offered to provide medical care, but that too has been denied—on the grounds that the trip . . . might kill him. People are trying to smuggle life-saving equipment to the boy. They, too, are being forcibly removed from the hospital. It was reported that Alfie’s father tried to administer mouth to mouth to his dying boy. Frankly, I’m surprised that he wasn’t arrested on charges of practicing medicine without a license. Tom Evans has said “This is not justice. This is a cruel bureaucracy.” He was right.

We’ve moved well beyond slippery slopes at this point. We’ve reached the Chthonic valley that lies at their inevitable destination, the foot of our own Taÿgetus—at the intersection of good intentions and ultimate power. This is where bureaucracy has replaced the moral compass; where we’re told by our self-described betters that we are morally deficient if we try to keep our children alive; that there is innocent human life not only unworthy of saving, but that warrants extermination. We’re starting to see, quite vividly, the moral and civic destination of the road we have been on since the turn of the 20th century when, drunk with the hubris of progress and the perfectibility of society, we began to willingly cede our freedoms and identities to the ever-broadening notion of the benevolent and matronly state. To let her care for us from cradle to grave. Mother, after all, knows best. In this case, she thinks its time that you let your child die—the cradle has become the grave.

How truly magnificent must it be to get your broken arm set for free when the only price you have to pay is the possibility of the state determining that your child die.

And what of those who would complain, who would criticize this perversion of good intentions into this ghastly spectacle? They will, of course, be investigated by the police. Chief Inspector Chris Gibson made clear:

Merseyside Police has been made aware of a number of social media posts which have been made with reference to Alder Hey Hospital and the ongoing situation involving Alfie Evans. I would like to make people aware that these posts are being monitored and remind social media users that any offences including malicious communications and threatening behaviour will be investigated and where necessary will be acted upon.

Of course, “malicious” is just broad enough to mean anything the prosecutorial authorities so determine.

What’s worse, is that large swaths of people watch this and determine that the parents, not the state, are the villains. Alfie’s young parents are dismissed as low class (“chavs” being the most common term bandied about by their social media detractors), with some of the more incendiary commentators suggesting that sterilization is best for the likes of them, anyway. I wonder how the conversation would turn if the baby were not born to those in the lower socio-economic strata that Tom and Katie occupy.

Just this week Kate Middleton and Prince William had a baby.  It does make one wonder if, should this advantaged child be so unfortunate as to become as sick as young Alfie, whether he too would be forced to die at the time of the state’s choosing? Would the new Royal Baby be allowed to travel to Italy for medical care? Would this child of privilege be denied access to life-saving care all because the state thought it knew better? Somehow, I think the royals would find a way around that. They always do.  

It’s a good thing then, that we in America—or at least those of us called “deplorable”—continue to cling to our guns and religion. We cling to them because they exist as constant reminders of who we are, the ideals we value, and the things we would stand against. Our guns offering both, symbolic reminders of, and real protections against, this kind of state encroachment on our rights. And our religion that—even to the non-religious among us—affirms the metaphysical basis for our natural rights and inherent dignity, guarding us against the kind of moral and spiritual rot that would allow seemingly good and intelligent people ever to consider that starving a child is ethically superior to allowing his loving parents to do everything in their power to extend his life.

Photo credit: Anthony Devlin/Getty Images

Administrative State • America • Congress • Conservatives • Democrats • Donald Trump • Elections • GOPe • Government Reform • Greatness Agenda • Obamacare • Post • Republicans • taxes • The Leviathian State • Trump White House

This Monstrosity of a Spending Bill Will Hurt Republicans

The omnibus spending bill passed in the dead of night and signed into law Friday, on the eighth anniversary of the Affordable Care Act, is bad policy and worse politics for Republicans facing midterm elections. Despite the GOP’s promises and congressional majorities, Obamacare is still the law of the land and the omnibus continues the unsustainable spending imperiling the country’s finances.

As the law’s details become better known, GOP voters’ already strong feeling of betrayal is growing so powerful that it may imperil the GOP majority. Feckless congressional leadership is getting most of the blame, but President Trump signed the bill and spent no political capital advocating his stated priorities. Power unused is power lost.

After the tax-reform package passed last year many of us believed the Republican Congress was finally showing signs of life and realizing why the American people had entrusted them with control of Capitol Hill and the White House. Failure to repeal Obamacare after seven years of pledges left GOP voters disheartened. But the victory of tax reform showed what Republicans could accomplish if they stuck together . . .

Read the rest at the Washington Post

Photo credit: Mark Wilson/Getty Images

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Democrats Fold on Immigration, America Wins

U.S. Senate leaders were all smiles Wednesday as they announced an agreement on a two-year spending plan. The House of Representatives passed a similar continuing resolution on Tuesday. Democrat threats to shut down the government are out, bipartisan backslapping is in. So how did this come together?

The Associated Press sums it up nicely: “Senate Democratic leaders have dropped their strategy of using the funding fight to extract concessions on immigration, specifically on seeking extended protections for the ‘Dreamer’ immigrants.

That’s a nice way of saying that Democrats folded. But why? Recall that just two weeks ago Democrats called a DACA-based amnesty nothing short of a moral imperative and “the civil rights issue of our day.” Rhetorical modesty is not considered a virtue on the Left. Neither, apparently, is constancy.

After the Schumer Shutdown turned into a public relations debacle Dick Durbin inveighed, Chuck Schumer threatened, and Nancy Pelosi…well, we couldn’t quite decipher what Nancy Pelosi said but we’re pretty sure it was meant to express Resistance™! They postured and preened for a few days but then Donald Trump offered them a DACA deal that gave them more than they asked for—nearly 2 million people legalized with a path to citizenship in exchange for some modest border security—and they walked away. Apparently, Democrats couldn’t take yes for an answer.

Trump called their bluff. Democrats never really wanted a DACA deal. Their histrionics were just crocodile tears. They really wanted two things: 1) an issue they could use to fill campaign coffers with money from coastal elites eager to signal their virtuous solidarity with immigration scofflaws they meet only in CNN’s hagiographies but never in person, and 2) a narrative of Republican villainy they could sell to credulous Resisters to keep them in a permanent state of hyperbolic outrage until election day.

With the end of Obama’s illegal DACA amnesty less than a month away, neither the House bill nor the Senate agreement contain any continuation of the program. The appetite for such a deal is, perhaps, larger when it comes from the executive than when legislators have to vote on it just a few months before facing voters. Neither the cheap-labor lobby nor the identity politics hacks in the Democratic Party will be happy, but this is a signal victory for Republicans who have, for once, sided with their voters.

The president deserves much of the credit. He led by example, providing Congress with the firmness of purpose and rigidity of spine that has been for so long lacking. And judging by the body language of congressional leaders, they like winning. Republicans are starting to show the signs of self-assurance that accompany victory.

Democrats, meanwhile, look on agog, unsure how to respond to the new script. To borrow a metaphor from Michael Anton, for years they were the Globetrotters—showboating, confident, sure of a win. And night after night the GOP dutifully played the role of the hapless Washington Generals: there for the show, but destined to lose. Not anymore.

Last April, I advised Republicans to “build trust and a sense of momentum within the party based on victories won together. Small victories will beget bigger ones.” It worked, but just barely. Republican Senators confirmed Neil Gorsuch and a slate of constitutionalist judges, they passed a major reform of the troubled Veteran’s Administration, and they reversed a number of harmful Obama-era regulations.

True, they made one major strategic error in 2017 when they tried to repeal Obamacare too soon. But that error may be forgiven. Who knew that John McCain, fresh off the campaign trail where he promised Arizona voters that he would vote for repeal—would torpedo the entire enterprise with what Lionel Trilling might have called an irritable mental gesture?

Republicans led by the president rebounded from that setback and passed a once-in-a-generation tax reform package that is already letting individuals and businesses keep more of the money they earn—and repealed the individual mandate, the most onerous and objectionable part of Obamacare. The tax cuts led to a raft of announcements from Fortune 500 companies of bonuses, wage increases, expanded hiring plans, and the promise of massive investments in the United States. Apple has announced plans to increase U.S. investment by $350 billion. Billion. Unemployment is low, the stock market is high, and there is renewed sense of the possible.

One need look no further than the launch by SpaceX of its long-promised heavy rocket. The reusable rocket takes larger payloads into orbit at a fraction of the cost fielded by competitors and then returns safely to earth, where it can be launched again. Is SpaceX a creature of the Trump era? No. But as investors, innovators, and entrepreneurs follow Musk’s example, pursuing their own projects they now operate in a friendlier business environment.

As the president’s congressional allies get a taste of victory and receive some well-earned kudos for their role in enacting the Trump agenda they build trust and will obtain the confidence to accomplish more. There is much yet to be done. The proposed spending bill includes an unsustainable deficit. That can be fixed by restoring the budget process to regular order. Obamacare still needs repeal and the deep state—unelected, self-interested, accountable to no one, out of control—must be brought to heel. There’s a wall yet to be built and pro-citizen immigration reform that ends chain migration and implements E-Verify yet to be passed. As the proverb says, slowly but surely the bird builds its nest. We’re not there yet, but today’s victory takes us one step closer.

America • Cultural Marxism • Democrats • Healthcare • Hollywood • Obamacare • Post • Republicans • The Media

Tears of a Clown

Jimmy Kimmel, you dissimul-
-late so poorly, that it’s crim’nal –
Cloaking activism in
A disguise supremely thin.

“A sounding brass, a tinkling cymbal”
Singing from the lib’ral hymnal –
Weeping your tears crocodilian –
Can that truly be fulfillin’?

Are your viewers’ lives so grim, they’ll
Applaud those tears, Mr. Kimmel?
Is that what they tune in for?
Will they ask for an encore?

Going out upon a limb, I’ll
Suggest to you, Mr. Kimmel:
No one needs another spokesman!
Why not simply tell some jokes, man?!



America • American Conservatism • Americanism • Congress • Conservatives • Democrats • Donald Trump • Greatness Agenda • Obamacare • Podcast • Republicans • Section 2 • The Left

Ben Boychuk with Chris Buskirk on Conservative Culpability

American Greatness Managing Editor, Ben Boychuk, AG publisher, Chris Buskirk, last week on The Seth and Chris Show to discuss the ways in which conservatives and Republicans are culpable for their own defeats because of their poor ground game and their tendency to engage in self-defeating intramural warfare. Have a listen:

Chris Buskirk:  Hi, I’m Chris Buskirk, he is Seth Leibsohn, welcome back to the ultimate hour of the Seth and Chris Show on the ultimate day of the week. Last hour of course, was the penultimate hour, yesterday was the penultimate day, but this is ultimate not only in the sense of final; but, ultimate, because we are joined by my friend and colleague, Ben Boychuk. He is managing editor at American Greatness and also a friend to the program. So, I think if you listen to this show a lot, you definitely know Ben. The world needs more Ben Boychuk on the radio. Right, Ben?

Ben Boychuk:   Yes. I agree. Thank you. Thank you for having me back.

Chris Buskirk:   Welcome. Yeah, it’s funny. I was laughing with Seth earlier in the show that the last time you were on he wasn’t here. But, the last time you were on, we were talking about Germany and of course, our listeners being what they are—that is smart, informed, intellectually curious, and knowledgeable—wanted to spontaneously, organically talk about German intellectual political history from the Treaty of Westphalia forward, because why not?

Ben Boychuk:   Because, that’s what you do on the ultimate hour.

Chris Buskirk:  Exactly right. Just like Dennis has the Ultimate Issues Hour, we just have the Ultimate Hour.

Ben Boychuk:   Yeah, that’s right. No, it’s good. Do I have to make another joke at Seth’s expense, or?

Chris Buskirk:  Well, since he just skedaddled out the door, I think you should.

Ben Boychuk:   I’m just … What can you say? I miss him.

Chris Buskirk:   Well, you can say anything. He’s not here to defend himself.

Ben Boychuk:   Yeah, that’s true. Listen, I wish him well. One of these days we’ll catch up.

Chris Buskirk:   Alas, poor Yorick! Alas, poor Seth! Ben, what do you think about … I’m just going to cut right to it on the healthcare thing and McCain. We’ve been talking about it here on the show for the past two hours almost. I thought we were going to do a little bit of it, but we’ve been taking calls non-stop. And, for people who are on hold, I am going to go back to the phones here in a little bit. But, I wanted to definitely have Ben weigh-in before we start taking calls again. Ben, I have to be honest with you. I am a little bit surprised that McCain came down on this this way, not 100 percent by any means—because, my suspicion always was that his real motivation was to undermine Donald Trump, not to do what’s right for the country or his constituents, or to keep promises, or any of those quaint notions we have about politics or any of those sorts of things.

But, Lindsey Graham is the sponsor. This is … Lindsey Graham and John McCain go together like peanut butter and jelly.

Ben Boychuk:  Or, something. I think his dislike of Trump seems to trump everything. I’m sure you’ve read the statement that McCain issued from his office and I’m sure …

Chris Buskirk:   Yeah, some things you can’t un-see Ben, and that’s one of them.

Ben Boychuk:  Right. So, he’s making a procedural point. He’s saying, “I cannot in good conscience blah, blah, blah. Because, we should be doing this in regular order and so on and so forth”.

Chris Buskirk:  Uh-huh.

Ben Boychuk:  I would say one thing slightly sort of in defense of … I mean, look. It’s not a great bill. Nothing that the republicans have had to offer on healthcare reform this year has been very good. They couldn’t manage a straight repeal and their replacement ideas have just not really been wonderful. But, what they are, what they would do and what this bill would have done, it would have initiated the process where they could … If they can’t do it in one fell swoop …

Chris Buskirk:  Do a piece meal.

Ben Boychuk:   They could do a piece meal, they could do it incrementally, they could do it in 12 steps instead of one. And, that’s certainly better than what we’ve got now, because Obamacare is a disaster.

Chris Buskirk:   Obamacare is a disaster. That’s right. Not that anybody in Congress would know, because they’re exempted from it.

Ben Boychuk:  Right. Yeah. No, that’s right.

Chris Buskirk:  I’m with you on this, Ben. I don’t love this bill. I’m not even sure I like this bill. But, it is still the best thing we’ve got and it is an improvement. I was saying on the show earlier, I don’t call this bill, just because I feel like I’ve got to be intellectually honest with myself, I don’t call this bill an Obamacare repeal, it’s not. But, it is an improvement and there are things to like in the bill. There’s just not that many. It’s a very thin bill, but as you say, it would signal that Republicans a) can accomplish something, they’ve accomplished nothing so far in Congress, anyway. And, it would also signal that they’re serious about handling the debacle that we call Obamacare and they’re not.

Ben Boychuk:   No, they’re not, especially the Senate. The Senate is useless. The House at least had some …

Chris Buskirk:   No, that’s right. Agreed on that.

Ben Boychuk:   The House made a good effort. The Senate is disastrous. I wish that … And, you would know this better than I do, because you’re in Arizona and I’m not. I don’t understand frankly, why McCain hasn’t left the Senate to take care of his health. He’s got a malignant brain tumor. He’s had to have chemotherapy. Why … I’m not sure he’s even doing the right thing for the country by remaining there. I think he needs to for the good of his health and for the good of his constituents, stand aside and let somebody else do it.

Chris Buskirk:   Right. Look, I agree with you. We hear that all the time. And, it’s a tough thing to talk about, because for the obvious reasons, but nonetheless, these are matters of national importance. Right? And, so people need to subsume their personal desires, wants, sensitivities beneath that. Because, that’s what happens when you enter public life. Particularly, when you enter it at that level.

Ben Boychuk:   Right. Now, that said. And, I know we’ll be taking calls on this later. That said, we have a piece coming up we’re going to be publishing on American Greatness, tomorrow that makes a point that sounding off about how McCain has betrayed us yet again isn’t necessarily … It’s an understandable urge and instinct, but Americans on the right in this country have been out-organized and just out-run on social media by the Left. The Left in its organization against any Republican plan to undo Obamacare, they’ve just been running circles around the Senate and Congress and the conservative movement in general. And, the Left has just been … They had … They’ve just been lighting up Twitter and Facebook. They’ve had excellent organization. You could text a number to a particular organization and they would automatically send a fax to Congress, to your member of Congress, to your Senator. They’ve got this thing locked down.

And Republicans, meanwhile, have been hard-pressed to make a straightforward case, to make a case that really moved or could move public opinion in their direction. So, you’re seeing all these polls that have come out today, The Washington Post poll and there’s been a couple of other polls talking about how the country is opposed to this bill. This bill, which nobody had heard of a week ago, but the organization in opposition to it has been so effective that people think they know enough to oppose it. I mean, it’s kind of crazy to me.

Chris Buskirk:   I saw the Washington Post poll, Ben, and I thought, “This means nothing.” In a sense, what I thought of was you know how Jesse Watters on Fox says he thinks it’s the typical man on the street thing, where you go like, “Oh, did you know we’ve got George Washington coming in the studio today. Would you like to join us and talk to the first president?” “Oh, yeah. I love him! He’s great!” People don’t know anything about this bill. You and I do this for a living and I would be hard-pressed to get deep into the details on this bill and I’ve looked into it.

Ben Boychuk:   Sure. And, a lot of the things that people are basing their opposition on are simply wrong. It’s incorrect.

Chris Buskirk:   It’s kind of like … Did you see the Jimmy Kimmel clip when he was sort of going off on his diatribe about this bill a couple days ago?

Ben Boychuk:  This is exactly what I was going to bring up.

Chris Buskirk:   Yeah, go ahead.

Ben Boychuk:   Because, the whole thing is about pre-existing conditions has become sort of the mantra. Anything that the Republicans do to change, repeal, modify, tinker with, tweak Obamacare means you’ll never get covered for pre-existing conditions ever again. That’s not true.

Chris Buskirk:   No, that’s not true at all.

Ben Boychuk:  And, Kimmel, I was chatting with our friend and colleague Julie Ponzi yesterday about this. Americans are hanging on the words of an ill-informed late night comedian about how to think about healthcare? This just shows the extent of which I think that the Republicans have really fumbled this issue. They’ve completely fumbled the message on this and the argument.

Chris Buskirk:  Ben, if Republicans in Congress weren’t fumbling an issue, they’d never touch the ball.

Ben Boychuk:    Right. Good enough.

Chris Buskirk:   Alright. That’s the music. We’re going to run to a break, then we’ll be right back with more of Ben Boychuk, Managing Editor of American Greatness. You can see what he is writing. You can see what American Greatness is publishing at We’ll be right back.

I am Chris Buskirk, he is Seth Leibsohn. Welcome back to the Seth and Chris Show. That was Blondie taking us back aways. This is Ben Boychuk. He’s our guest for the hour. He is also the managing editor of American Greatness. Ben, this piece that we’re going to publish tomorrow I think is interesting. Is there a prescription offered within the piece? We get out-hustled, we get out-organized by the Left. They are better at legislating than we are. When I say we, Republicans, conservatives, generally. It hasn’t always been that way. There was a time in our lifetimes when Republicans knew how to get organized and to legislate in Congress. What’s the way forward?

Ben Boychuk:  One of the recommendations that the piece makes and the author is a fellow by the name of Nathaniel Wright. He’s written for us from time to time. He says, “Really what you’ve got to do, it’s right there in the resistance tactics, there’s something called the Indivisible Guidebook,” which we’re going to link to from this story. And, he says, “Look, it’s just as useful for conservative activists as it is for leftists if we choose to use it. The tactics are all perfectly legitimate tactics for organizers on the right to use as they are on the left.” The one thing that we have been sort of inconsistent … You know, the tea parties were good examples of where grassroots activists could really get out and get things going. And, that simmered down some. In part for some legitimate reasons. Tea parties have kind of focused more on certain elections, getting certain politicians elected. They would have … I think in some areas a little bit more robust at getting local folks elected, but we had the tea party election a few years ago and we got some decent folks elected to the House and the Senate.

But, in terms of keeping that enthusiasm up and keeping it high, it’s often easier to organize in opposition than it is to organize in favor of something. So, conservatives are nothing if not really good at opposing stuff. It’s one of the reasons why we don’t govern so well. It’s because we want less of what government does, not more of it. And, so we tend to … We mount effective opposition and we’re not so great at …

Chris Buskirk:   I would say maybe we mount loud opposition. Effective I’m not so sure about.

Ben Boychuk:   Well, yeah. That’s a fair point. That’s a good correction. And, so. I go back to what we were talking about before the break. The Left when it came to mobilizing against really any Republican proposal to tinker with Obamacare, doesn’t matter what it is, they’ve got their talking points. They’ve had their protestors showing up at the town halls and just scaring the dickens out of these elected officials who are easily scared. And, they’ve cowed them, really. Certainly the Senate has just been utterly stymied. And, so when as you pointed out in the first segment, where McCain isn’t even voting for his bosom buddy pal Lindsey Graham’s bill. It’s really quite pathetic to see.

Chris Buskirk:   You may not have tracked with us just being outside of Arizona, it was bigger news here perhaps than elsewhere, but maybe you did. When McCain, as I like to phrase it, voted to retain Obamacare two months ago, the rationale that he gave at the time was that Arizona’s governor, Governor Ducey, basically told him to do so. He said that he was opposed to that bill and that was true. Ducey was out in public opposing that bill, which by the way is better than this bill. It was a little closer to an actual repeal. Not a real repeal, but still. It was a better bill. Ducey opposed it, McCain basically tried to pin it on the governor saying, “Oh, you know this wouldn’t be good for my state. My Republican governor told me so. So, I voted against it.” Okay. I don’t believe it, first of all. But, okay. If that’s your rationale. This time around, Ducey’s out in public saying, “Yeah, this is a good bill. Support it.”

Ben Boychuk:   I hadn’t heard that.

Chris Buskirk:   Yeah, I know. There’s these serial lies and that’s why for the past two and a half hours, we’ve had full phone lines on the show, because people don’t like being lied to. Especially about something as important as this. If you say, “Look, I want to see the marginal tax rate of 15%” and you vote for a marginal tax rate of 22.5%, people are like, “Oh man. That guy.” When it’s something about, “Oh, I can’t get healthcare anymore” or “My deductible is 10 times what it used to be and my premium is three times what it used to be, and I can’t get to the doctors I want.” That really hits people where they live.

Ben Boychuk:    Right. And, this is part of the agony of this debate is that there’s a decent argument that this particular bill wouldn’t do all that much for premiums, but it would … If you’re tinkering around the margins, all you have to do is get something passed that’s marginally better than what we’ve got now, because what we have now is really rotten. Get something passed that’s marginally better than that and then you work from there.

Chris Buskirk:  You go from moving in one direction to moving in the other direction. That’s important.

Ben Boychuk:   Right. And, yes, as McCain said in his statement today, yes, it’s one-fifth of the nation’s economy. Yes, there are inherent risks in future Congresses and future administrations monkeying around with whatever they come up with. But, really what you want though … First of all, that’s kind of what legislation is supposed to do. It’s not always one and done. It took years, it took decades to put in place the Medicare and Medicaid system we have now and that’s partly why it’s in such dire need of reform. It’s going to take time and the excuses—as  you were talking a minute ago about his—I almost kind of can imagine McCain or someone from his office saying, “Well, that was two months ago. This is now.” It’s whatever is expedient, but that works both ways, Chris. Whatever is expedient to oppose it, there’s also some expediencies in supporting it. And, again. As long as they can get something done, that’s better than nothing.

Chris Buskirk:  Yeah. You know, Ben. What I think … I think people are smart. We see that all the time. People are smart. They have common sense. It’s tough to pull the wool over their eyes. People understand pragmatic politics. They understand prudence in politics. But, when they smell a rat, they smell a rat. This just sounds like somebody who’s not operating in good faith. And, that’s what really drives people up a while. That’s what drives people crazy. It kind of goes back to the tax thing. Okay, you want a 15%, you got 22. Alright, you kind of split the baby. This is different than that. This is somebody who just does not appear to be acting in good faith.

We’re going to go to a quick break, when we come back we’ll take a couple calls. We’re going to stay with Ben Boychuk for the remainder of the hour. He is the Managing Editor of American Greatness. You can find his work at We’ll be right back.

I am Chris Buskirk, he is Seth Leibsohn. And, this the Seth and Chris Show. We’re joined by Ben Boychuk, Managing Editor of American Greatness. Friend of the show. Friend of mine and a Renaissance man. You can do it all, Ben. You can do music, too. I happen to know this. We don’t ever do it, but you can do it.

Ben Boychuk:  Yes, I can. I used to play drums, too.

Chris Buskirk:   See, I did not know that. I did not know you were a drummer. Okay, so. Buddy Rich or Gene Krupa?

Ben Boychuk:  Buddy Rich.

Chris Buskirk:   Yeah see, I think so too. Seth and I have done this before. We both agree Buddy Rich, but not a pleasant person, by the way. I don’t know if you’re aware of this. Had a terrible reputation in show business.

Ben Boychuk:   Oh, yeah. Have you heard the audio? There’s a piece of audio that’s gone around for years and years and years. Like, decades. One of his band members recorded it secretly of him just berating, just tearing into his band about a variety of things. Apparently, it was a union beef or something. But, yeah. He was not a pleasant man, but what a great drummer.

Chris Buskirk:  Not a pleasant man, but what a great drummer. That’s the epitaph for Buddy Rich, I guess. We played him in the bumper music quite a bit. I love Buddy Rich. I did not know that you were a drummer. We’ll have to take this subject up at a later date where we can run the music part of this show at greater length. In the meantime though, we’ve got a bunch of calls. People who want to get in on the McCain discussion. You up for it?

Ben Boychuk:   Oh, sure.

Chris Buskirk:    Let’s take Hal in Prescott, Arizona. Hal, how are you? Thanks for holding.

Hal:   I’m very well. Hey, thanks for taking the call. Great show.

Chris Buskirk:  Thank you.

Hal:   Just had some brief comments. You know, in 2012, my insurance premium was a large cable bill. I still have the same politically incorrect non-Obamacare policy and it’s a small car payment. My brother has an Obamacare policy that’s a year old, his premiums are rent plus deductible. It’s ridiculous. So, thank you, John McCain.

Chris Buskirk:    The premiums go up and in exchange for paying more, you also get to have higher deductibles and bigger co-pays and fewer doctors who want to see you.

Hal:   Yeah. It’s a disaster and it’s probably going to take decades to unwind it, quite frankly. Which, kind of brings me to my next point. You guys are familiar with the essay The Flight 93 Election? Well, I would suggest we have a flight 93 president. We need a flight 93 Congress. And, I think this is how we engage ordinary people in opposition to this establishmentarian nonsense. And, the question you ask these clowns who are in Congress is, “Will you exempt yourself from the rules you make for us?” And, if they say yes, they get primaried.

Chris Buskirk:  Right.

Hal:    And, if they say no, you say, “Hey. Here you go. You’re with us ordinary folks out here who are working hard and pulling the wagon. We’ll help you out.”

Ben Boychuk:   The only thing I would add to that is trust, but verify. ‘Cause, you know how it is. These guys campaign one way and then once they get in, they act another. And, they always have plausible, if completely unscrupulous excuses.

Hal:   They grow in office.

Ben Boychuk:  Right. And, the guys who take the term limit pledges who end up staying for 25 years.

Hal:   That’s how you know how you get rid of them. Oh, you went back on your word? Guess what? You’re done. We’re not going to support you anymore. And, we’re moving on. And, maybe have some protesters outside their house or something like that, ’cause that’s what the liberals do and they’re pretty good at it.

Ben Boychuk:  They are. They’re very good at it. I think one of the problems with politics in general and one of the … I think it tends to afflict our side more than it afflicts theirs is short memories. Short memories and short attention spans in some ways. The benefits of incumbency and once they get in, it’s very hard to get them out and I just … We need to do better at staying on top of these folks. So, I agree with you. I’m just adding a little shade to it. I think that’s right.

Hal:   The hardest part is how do you keep people engaged? And, what we need are some entrepreneurial people to start thinking about these problems. ‘Cause, they have a lot of people who do this for a living. That’s their sole reason for existing as opposed to me who actually has a real job. So, guys. Great show. Thank you.

Chris Buskirk:  Thanks a bunch, Hal. I really appreciate the call. Ben, this is … Short memories, it’s like short attention span theater. Right? We have to hold people accountable. I know one of the ways people have wanted to do that for a long time is term limits. It keeps coming up again and again. I used to take a line that I know you’ve heard seriously, which is, “Yeah, we have them. They’re called elections.” I’m not sure that’s the right answer anymore. I think I’ve changed my position on this over time. Seth and I had this out on the show a couple months ago and it was like today, we wound up probably getting 50 calls within 10 minutes on it. It’s one of those things that comes up for one reason. People are frustrated with the way that the system is working now. They don’t feel like it works for them.

We’re going to have to leave it there. We’re going to come back on the other side of this break with more with Ben Boychuk from American Greatness.

Chris Buskirk:   Alright, Ben. Where do you stand on Kenny Rogers?

Ben Boychuk:   I like his psychedelic stuff.

Chris Buskirk:   Oh, the 60’s.

Ben Boychuk:  Yeah.

Chris Buskirk:  That’s not the New Christy Minstrels era, is it? That was a separate era?

Ben Boychuk:  That was … What’s the name of the band? First Edition? No, wait. Someone will know. Some caller on the line will know. But, I just dropped in to see what condition my condition was in.

Chris Buskirk:   Oh, yeah. Boy. So, you do know your Kenny Rogers. I haven’t heard that for I don’t even know how long.

Ben Boychuk:  I’ve got that on heavy rotation on my …

Chris Buskirk:  Do you really?

Ben Boychuk:  I’ve got a playlist for my car. It’s called, “In the car for 10,000 years” and it’s got like 1400 songs on it. And, it comes up quite a bit.

Chris Buskirk:  If it comes up quite a bit, that means you’re rotating through 1400 songs a lot. You’re not an Uber driver secretly, are you?

Ben Boychuk:  No.

Chris Buskirk:   A truck driver?

Ben Boychuk:  I don’t have that kind of time.

Chris Buskirk:   A long-haul trucker. Long-haul trucker and Managing Editor of American Greatness. There actually is something to that, right? You get out, you see the concrete. You interact with real people. You’re not at a desk in an office some place in Washington, DC. Those things would go together.

Ben Boychuk:   Right. No, no. It’s the mundane reality of it is when you live in Southern California …

Chris Buskirk:  You’re on the road.

Ben Boychuk:   Everything is an hour away.

Chris Buskirk:  Going out to get your mail is kind of like in LA Story, the Steve Martin movie where he takes his car down the driveway to pick up his mail.

Ben Boychuk:  That’s right. Yeah. It’s almost as bad as that, yeah.

Chris Buskirk:  Hey, Ben. I want to switch gears on you from John McCain and healthcare to what’s going on in Alabama. In that, we’ve got Luther Strange who is the incumbent. He’s basically the Mitch McConnell pick. We’ve got Judge Roy Moore on the other side. He’s not Donald Trump’s endorsed pick, but he really is the Trump-ist candidate, if we can put it that way. People have been calling it the Strange-Moore race. I call it the Moore-Strange race. Right, Ben? Not Ben, sorry. Bill. I’ve got a little audio here that you might recognize.

Audio Clip:  What’s happening, Luther? I’m sorry about the door, man. Did that hurt? It looked real painful when you slammed into it.

Chris Buskirk:   Yeah, Luther. Luther might be running into a door named Roy Moore this Tuesday. How do you see it?

Ben Boychuk:   So, Luther Strange has a big problem. And, that is he is sort of an ambitious, craven opportunist who accepted an appointment from the governor of the state while he was investigating the governor.

Chris Buskirk:  And, people get cynical about politics? I can’t imagine why!

Ben Boychuk:  Yeah, no. I’m sure it was all very much on the up and up. So, yeah. So, Luther Strange … So, there’s a little bit of a tension here, because President Trump has endorsed Strange and Roy Moore has the endorsement of a lot of our Trumpist friends. Is there maybe a kind of a break? Is there trouble in the family? I don’t think so. I think the president is taking some advice from some folks and the people of Alabama can judge accordingly. Strange hasn’t been in there that long, but he’s been in there long enough to know that he’s McConnell’s.

Chris Buskirk:  He’s McConnell’s … ?

Ben Boychuk:  Boy.

Chris Buskirk:   That’s the word.

Ben Boychuk:  Yeah.

Chris Buskirk:  This is something that people don’t appreciate outside of Alabama, which is this weirdness, that’s the nice word for it, that is Luther Strange. The guy took a blatant pay-off in being appointed to the Senate from the guy he was investigating.

Ben Boychuk:    Right.

Chris Buskirk:   The people in Alabama know this. The people in Arizona might not know it. The people in Maine might not know it, but all the people who are voting in this election on Tuesday in Alabama, they all know it and they know it stinks.

Ben Boychuk:    Yeah. That’s right. That’s why Roy Moore, who is no angel—he’s got an interesting checkered history—he was on the state supreme court, got kicked off twice. He’s got some baggage, too. And, as we were talking to the caller in the last segment, he’s made some … He says he’s with the president on his agenda. He’s made a lot of the right noises as far as these things go. So, let’s see what happens when he gets in there. Personally, I think one of the better reasons to … And, Moore is not great, but compared to Strange and when you read reports. Like, there was a story at CBS News saying that some sitting senators are worried that Moore might get in, because he would be “A disruptive influence”.

Chris Buskirk:  That’s almost like an endorsement in kind.

Ben Boychuk:  Exactly. Whatever misgivings you may have about him and his history, you almost kind of want to go, “Yeah, that …”

Chris Buskirk:  Oh, wow! Sitting senators think he’d be a disruptive force?!

Ben Boychuk:  Beautiful.

Chris Buskirk:  I’m in!

Ben Boychuk:  That’s right. Beautiful, where do I send my check?

Chris Buskirk:  This is one of those places where it is bizarre. The optics are bizarre, because you’ve got Donald Trump. He’s out there right now. I believe he’s still speaking down in Alabama at a rally for Luther Strange. But, I think of this as a “Do as I do, not as I say” moment. In other words, Trump is endorsing Luther Strange, but go with the guy who wants to do what Donald Trump actually does.

Ben Boychuk:   Sure.

Chris Buskirk:  Right? Go with the guy who is on board with the Trump agenda. I don’t know about you, but I think maybe winds up being a three, four, maybe even five point race. But, I think to Moore.

Ben Boychuk:  Yeah, that seems likely. And, I’ve got to say something else, too. We’ve talked about this on the air before and early on, I think after the presidential election last year and then early on in the administration. And, just to be totally transparent with the audience, that’s the motto, right?

Chris Buskirk:  Yup.

Ben Boychuk:   I was a reluctant Trump supporter.

Chris Buskirk:   You were a late adopter.

Ben Boychuk:  I was kind of a latecomer, but everything that I’ve seen so far and knowing what I know, I have no complaints, really. The disruption that Trump has brought to Washington, D.C. for people of a traditional kind of conservative temperament, they might be uncomfortable with it. But, it’s necessary. It’s so vitally necessary. And, so, again like Roy Moore to bring disruption to the Senate would be necessary, because the circumstances in which we find ourselves with a permanent administrative state … People are reasserting their sovereignty. And, that’s what Trump represents and that’s what potentially a senator Roy Moore would represent.

Chris Buskirk:  Yeah. I think that’s right. That leads me to my next question. You can hear the music, a little Buddy Rich there. You can hear that. But, in the final segment, which we’ve got coming up next, what I want to just kind of touch on is what does this mean for our politics? I don’t mean this at 50,000 feet. Depending on who wins, what is this going to mean for the 2018 race and what does this tell us about where conservatives and the Republican Party are going. That’s why everybody’s dumping millions of dollars into this race, because they see it as a signal event. We’ll be right back with more of the Seth and Chris Show.

This is the Seth and Chris Show final segment with Ben Boychuk, Managing Editor of American Greatness. Ben, I want to give you the last word here. So, kind of a two-parter here. But, take your time. What happens, I guess depending on how this race down in Alabama goes, what happens if Roy Moore wins? What’s the political fallout or repercussion of that? How does it play out I guess in the politics inside DC between now and November of next year. And, how does it play out in terms of the electoral politics of the upcoming congressional election? And, the second part is before we have to sign off, just let everybody know what’s going on at American Greatness and where they can check it out.

Ben Boychuk:  Sure. Well, as for the first, I imagine that the response inside the beltway will be abject panic, because … Yet another interloper, another disrupter.

Chris Buskirk:  The barbarians are at the gates!

Ben Boychuk:  Right.

Chris Buskirk:   No, hold on a second. They’re inside the gates!

Ben Boychuk:  That’s right. And, so. I imagine you’re going to see quite a bit of panic there. It will be interesting to see if this sort of phenomenon can be exported from the South. The South is very red, in the red/blue state divide. And, so it will interesting to see how that will go in the mid-terms next year, because … Remember immediately after the presidential election, there was a lot of talk from analysts and so forth. Like, “Oh, Trump has no coattails.” There were some other … There were a few congressional candidates, including the …

Chris Buskirk:  These are the same ones who said Trump couldn’t win, right?

Ben Boychuk:  That’s right. And, that he has no coattails. But, there were a few candidates who kind of ran in the sort of Trumpist vein of challenging sort of establishment republicans and they didn’t succeed. So, on the basis of that, the thought was, “Well, Trump is his own. He’s unique. He won’t have any sort of … This isn’t going to go very far.” Well, now that we’re seeing the administration and we’re seeing basically Trump winning a lot of these special elections or Trumpist type candidates winning special elections, beating back so-called resistance candidates from the Left. And, if you see an establishment Republican get taken out in the South on Tuesday, well then, okay. Then, we’re cooking. We’ve got a movement here.

I hear the music, so let me just say real quick … American Greatness, several great pieces this week. Check us out on the weekend. I want everybody to read that Nathaniel Wright piece that I was teasing earlier in the hour about John McCain’s betrayal, about our own culpability in this.

Chris Buskirk:  Five seconds.

Ben Boychuk:   But, lots to read at

Chris Buskirk:  Ben, thanks so much. We’ll talk to you again real soon. Have a good weekend, everybody. We’ll be back Monday at three.



Administrative State • Americanism • Education • Healthcare • Immigration • Obamacare

America’s Ailing Healthcare System Depends Upon Immigration—And That’s a Bad Thing

Now that President Trump has signaled his support for the RAISE Act, many Americans are being forced to think about the merits and pitfalls of our legal immigration system. One key problem that has received no attention is how the large-scale immigration of foreign physicians has contributed to the atrophying of U.S. medical schools.

Specifically, America’s universities can no longer train enough medical practitioners to meet the nation’s health care demands—America relies on the immigration of foreign professionals to maintain its health care system and standard of living.

In a sense, we rely on imported physicians like we rely on foreign oil.

Before beginning, let’s be clear: there are more physicians per capita in America than at any other point in the nation’s history. The same goes for nurses, physiotherapists, and mental health professionals. This is good. But it’s also worth examining how we got here: was the process organic, or artificial? Do we, as a country, actually have the educational infrastructure to train that many professionals, or are we living in a consumption bubble?

Unfortunately, we are in bubble territory. In 1982-1983, America graduated roughly 16,000 physicians. This number has barely budged since. In fact, in 2015 America graduated just 18,705 physicians—that is, 17 percent more. During the same period, America’s total population increased by 39 percent, from 231.7 million in 1982, to 322 million today.

In a closed system, we would have expected to see the physician-patient ratio deteriorate over the last few decades—but the opposite has happened. Why?


According to data from the Migration Policy Institute, nearly 17 percent of America’s 12.4 million healthcare professionals (including physicians, nurses, dentists, and therapists) are immigrants. They more than make up for America’s training deficit. Out of interest, the percentage of foreign-born surgeons, as a sub-category, is even higher, at 28 percent. For nurses, it is 24 percent. The data is unambiguous: America’s healthcare system needs immigration to function.

Why does any of this matter? The legal immigration of physicians, and medical students, is clearly a good thing, since it provides us with a better quality of life. This is true. But, too much of a good thing can also be harmful. Immigration is causing two large problems: First, the displacement of American students with more profitable foreign students, and, second, systemic atrophy.

The first challenge is relatively straightforward, and doesn’t warrant much discussion. Essentially, there are a finite number of spots in U.S. medical schools, and an increasingly large percentage of those spots are allocated to foreign students, who are often charged extra (and are therefore more profitable).

This denies a large number of American students access to good educations and lucrative professions—all because of profit-incentives. This is, in fact, the main reason why native-born Americans are being locked out of professional programs; it’s not that Americans are dumb; it’s that foreigners out-bid them. My point is that America’s higher education system should work in our national interests, that is the promotion and education of American talent, rather than fleecing wealthy foreigners.

On the second point: America’s medical schools are atrophying, and our health care infrastructure is now wholly inadequate to keep pace with increasing demand. In the time before mass immigration, if America’s population increased, America needed to train more physicians. That meant more investment in universities and education, in better training programs, and so forth.

Immigration provided a shortcut, and because of this our education system is 40 years behind. First, it is relatively small—we should be graduating roughly 30,000 physicians annually to maintain our current physician-to-patient ratio. Second, training programs are becoming dilapidated relative to other Western or even developing countries—there is a strong preference for, say, Canadian or Filipino nurses in U.S. hospitals because our own programs are relatively poor or lack capacity. This is a rather biting fact, but it is a fact nevertheless.

Immigration may be a shortcut to better healthcare, but it’s also a short-term solution. In the long run, we will need to invest in ourselves, and end the addiction to immigrant labor. Until then, we are simply injecting fragility and dependency into the healthcare system.


2016 Election • America • Congress • Conservatives • Deep State • Democrats • Donald Trump • Foreign Policy • Government Reform • Greatness Agenda • Healthcare • Neil Gorsuch • Obama • Obamacare • Republicans • self-government • separation of powers • The Media • The Resistance (Snicker)

Polls Don’t Tell the Tale—Trump’s Support is Deep. Here’s Why…

As a conservative Republican, I harbored concerns when I voted last November for Donald Trump to be my president. I knew that I had to vote for him, given the unacceptable alternative of an incompetent liar who had placed me in a basket of “Deplorables”; had destroyed 33,000 emails that she covertly maintained on her bathroom server while telling me that the emails all concerned yoga classes and wedding dresses; had lied to me and the families of those who fell in Benghazi about what had really happened there on another 9/11; and really had nothing to show for decades of public activity but a résumé of failure from HillaryCare, Whitewater, and Travelgate to a mediocre tenure in the State Department.

Her “Russian reset” had been a disaster. She had met many dozens of world figures, logged many thousands of miles of air travel, and had eaten well at many state banquets, but she had nothing of lasting substance to show for it all. During her State Department tenure, the “Arab Spring” devolved into a nightmarish winter. ISIS grew from a junior varsity to the major leagues of barbarism and terror. And she even had found the opportunity to scream on the phone at the Prime Minister of Israel, while denying the Jewish right to build without restriction in Jerusalem.

So I voted unhesitatingly for Trump. But, again, I had concerns.

Although I recoiled from the Republicans-in-Name-Only and “Never Trumpers,” I did share some of their bemusement. Would he be a true conservative, or was he really a liberal and a conservative hybrid at once, a man bereft of grounded ideology who simply tilted with the direction of the day’s breeze, capable of being turned by the last voice to compliment him?

Would he truly appoint conservative federal judges and Supreme Court justices, or would his judicial legacy be another Republican flop like the Nixon liberal appointments after Clement Haynsworth and G. Harrold Carswell, or like George H. W. Bush’s disastrous appointment of David Souter? Would he keep his promises? Would he have a clue?

That was then. Now, six months into Trump’s first term, I could not be more pleased with the president we elected. He is better than I ever imagined, and he is the real thing. That is the reason that voter surveys continue to show that President Trump has not lost any support among the base who elected him, and that he does as well now as before in the counties throughout the country that he carried as his base.

So What? Who Cares?
I do not care a whit about the “Russia stuff.” That is what I call it: the “Russia stuff.” Whether it is about Russian “collusion” or deals that Jared Kushner did or did not negotiate, or whom Attorney General Jeff Sessions met when he was a U.S. senator, or where former Trump campaign chief Paul Manafort did business, or the telephone contacts of Michael Flynn—the moment that I see the word “Russia” in a headline about  the White House, I skip the story. Although I am a “news junkie,” I simply do not care. For me, the subject has as much relevance as a soccer game: Yawn.

I even have stopped watching almost all of Fox News, even though Tucker Carlson’s solid conservatism is an improvement over Bill O’Reilly’s softer version, and the network is so much stronger without Megyn Kelly and Greta Van Susteren. I simply have no more interest in wasting my time with “fair and balanced debate,” to sit and listen to some liberal hack named Tarlov or Roginsky recite memorized talking points, or a fool named Marie Harf who used her State Department platform to explain that ISIS beheadings stemmed from a lack of job opportunities. (Remember: #JobsForISIS?)

For my news I have moved to the Fox Business channel, and I treat myself to Stuart Varney, Melissa Francis, Lou Dobbs and insightful conservative guests who do not waste my time. And, although I once was a Johnny Carson and Jay Leno regular, I no longer watch those late night talk shows. Instead, I choose between Ken Burns documentaries, MLB.TV’s “Quick Pitch,” and studying the Talmud. Same for “Saturday Night Live.” The moment the Washington Post began reporting every Monday on that show’s latest political slams against the Trump White House, I decided to turn elsewhere for my Saturday night entertainment. Besides, that show stopped being funny decades ago.

But what about all of Trump’s tweeting? Is Trump a nut? And what about the time he devotes to tweeting and to watching “Fox & Friends” and “Morning Joe”?

I don’t know. Maybe he is a nut. Yet, as an Orthodox rabbi who has counseled hundreds of people over 35 years, and as a high-stakes litigation attorney who has counseled and represented hundreds more, I will share a secret that is not protected by any professional rule of privilege: most people are nuts. (For verification, just ask their spouses, their parents-in-law, and their grown kids.) And most people have side hobbies that “waste time.” I wasted time these past four months watching the Mets. How many hours did President Kennedy waste running after Judith Exner, Marilyn Monroe, and others whom I do not know—and keeping it all secret from his wife? How many hours did President Nixon waste dealing with the Watergate cover-up? How many hours did President Ford need to devote lovingly to his wife as she battled bravely to overcome certain private challenges? How many hours did President Clinton set aside for Paula Corbin Jones, Kathleen Willey, Monica Lewinsky, and dealing with the subsequent fallout emanating from them and from Juanita Broaddrick?

It would seem that the only president who initially wasted no time but devoted every moment’s focus to every detail of government was Jimmy Carter. How did that work out? In the end, he was consumed by the Iran hostage crisis, and we were consumed by him.

Does Twitter take more time away from the work day than those distractions? How long does it take to type 140 characters, even in five or six strings?

What Really Matters
We conservatives do not care about these side stories and Democrat smokescreens that aim to divert this president and us from the agenda to make America great again. Rather, here is what we have come to know these six months since Trump took office:

Republicans have won every seriously contested Congressional election since President Trump was elected. It is absurd to think that, when push comes to shove, Republican voters in 2018 would allow Red State Democrats to sweep the U.S. Senate merely because Chuck Schumer and Elizabeth Warren engage in screeds, while in the House, Maxine Waters calls for the president to be impeached or exiled, or both.

We do not mind that the president fired FBI Director James Comey. This is a man who we now know leaked secret internal information to the New York Times. Notwithstanding that Comey did not trust the president, it was just as reasonable for the president to determine that he could not trust Comey—just as the Democrats long before could not trust Comey and also wanted him fired. Comey interfered with the election process more than Vladimir Putin ever did, arrogated to himself the authority to absolve Hillary Clinton despite his own recognition that she had committed serious federal crimes, and never dealt with the Deep State within his department.

President Trump somehow has managed to lead for six months, despite the most hostile media gangland in a century and more, and he has gained important governing experience along the way, just as the neophyte Obama learned his way around after arriving at the White House with little more than a background in community organizing, a pair of Greek or Roman columns, and a paperback copy of Saul Alinsky’s Rules for Radicals.

President Trump has appointed an extraordinary team of cabinet secretaries, and they are a better and more reliably conservative team than Ronald Reagan ever assembled. While President Reagan not only named Antonin Scalia to the Supreme Court but also Sandra Day O’Connor and Anthony Kennedy, President Trump has named Neil Gorsuch, and the future names in waiting are likely equally impressive. For all the “Resistance” tactics that the Democrats deployed during the Gorsuch battle, the president did not give ground, and he leveraged Harry Reid’s blunder of ending the filibuster rule for federal judicial appointments to get the nomination through. The president’s team now is working to fill the 129 other open federal judicial seats awaiting judges. As he proceeds, we will see balance return to the federal district courts that conduct trials and the federal appellate courts that ultimately settle most of America’s laws, and his own immediate experiences in seeing his entry ban navigate through the courts has taught him that federal judges matter on all levels.

On the energy front, we no longer awake each morning to learn of new Obama-era regulations aimed at strangling American energy independence. Instead, the Keystone XL pipeline was approved, as promised. Obama executive orders have been reversed at dizzying speed. Although a new era has changed the place of “King Coal” in the energy spectrum, the “War on Coal” is ended, as promised, and America is back on the path to end its partial dependency on the dirty oil produced by dictators and thugs from Venezuela to Saudi Arabia—oil drilled and extracted in tyrannies where environmental concerns are a joke—and we now even are inducing allies like Poland in Europe to consider moving their own energy contracts away from Russia and towards the United States.

Trump promised action on immigration, and he has begun the process of inviting bidders to compete for federal contracts to build that wall. Truth is, most of us do not care ultimately who pays for it; we separate his bluster from his substance. That substance already has driven down illegal immigration markedly. And the “bad dudes” really are being hunted by ICE and are being deported or locked up, not merely released on their own recognizance with a promise maybe someday to show up for an immigration hearing, perhaps.

The Underlying Challenge: Congress
We know that the reality of democracy is complicated, and that our Founding Fathers crafted an elegant system of checks and balances for a reason.

Yes, the Republicans now control the House, the Senate, the White House, and the Supreme Court—for which we all thank Barack Obama daily—but the sophisticates among us also recognize that 52 Republican Senators is too razor-thin a margin for a bold Trump agenda to flourish.

For example, Susan Collins represents Blue Maine, and she simply cannot be a Tea Party senator. We need another half-dozen Red State Republican senators, and contrary to the common wisdom, help may be on the way.

Meanwhile, we know that President Trump has done his best to corral the team to reverse the tragedy of Obamacare, but he has been disrupted meanwhile by a crazy filibuster voting rule, an even crazier series of rules regarding “reconciliation,” a liberal Democrat stationed as the Senate’s “Parliamentarian,” and an utterly incoherent and incomprehensible rule regarding the Congressional Budget Office whose projections repeatedly have proven false and imaginary in health care and everything else. If people are told that they no longer will be penalized and coerced to buy health insurance they do not want, of course millions will drop the plans foisted on them. That is not properly termed “millions losing insurance”; that is “millions choosing of their own free will not to pay for something they do not want and do not value.”

We know this president and this Congress will pass a major tax cut before the 2018 elections because Trump wants it, his economic team has it mapped out, and the House and Senate would not dare go to the voters next year without a tax cut. Watch for Red State Democrats, facing electoral elimination, to be passionate supporters of a Republican tax bill. It will happen, and this president will sign it. Of that we have no doubt.

Cut Through the Noise These Next 18 Months
So we have a very strong determination to stand by this president, to give him more Senators in 18 months, and to give him another four years in Washington before Maxine Waters exiles him.

We do not care that Europeans and their leaders like America less now than they did when Obama was president. Most children like their grandparents more than they like their parents because Gramps and Granny have no rules, feed them candy, and let them stay up all night, while the parents make the kids do their homework, brush their teeth, and clean their rooms. Obama was cheered by throngs in Berlin, giggled with Hugo Chavez, and salsaed in Cuba in front of Castro. Sure they loved him—they even gave him a Nobel Peace Prize, just as they previously had given one to Yasser Arafat, before he did anything.

We want a president who goes to Europe, tells them to pay the bills they promised to pay NATO, and gets results. We want him extricating us from climate pacts and trade agreements that do not serve our interests. Along the way, our allies from Japan to Israel to England know they now have a reliable leader in the White House, not a team of kibbitzers who send James Taylor to Paris to sing “You’ve Got a Friend” as an American response to the Charlie Hebdo massacre in France.

Americans want jobs, and this president now is forward on rebuilding the nation’s long-neglected infrastructure, while emphasizing the importance of “Buying American” and restoring America’s historical role in manufacturing. We want lower taxes and an America where we pay only for the health coverage options we want. We do not want to pay for Sandra Fluke’s birth control pills or Planned Parenthood’s abortions, although many of us are copacetic with their family planning and social counseling. We want trade agreements that protect American jobs and that recognize that international polluters like China and India and the misogynistic Arab oil sheikhdoms need to catch up with our clean-environment practices before we continue marching like lemmings over industrial cliffs while the mass polluters scoop up our forfeited interests.

As the president now begins his next six months in office, we among his supporters have learned to tune out the nonsense that defines the lazy legislators in the Washington Beltway who prefer to mull over Mueller than to craft landmark health legislation that passes.

Yes, we have seen the president mature in office. He has made some important pinpointed staff changes. He is moving away from abiding the daily media circus. For those Democrats who warned with alarm and portents of peril that Donald Trump could not be trusted with the nuclear codes, we have seen that he has assembled a remarkable defense team, that he has authorized a surgical MOAB strike in Afghanistan and the dispatch of 59 cruise missiles to bombard clearly designated Syrian targets without embroiling us in a Middle East war that America should avoid. He has acted with care and delicacy in confronting the serious problem in North Korea, giving the lie to those who argued that he would be hot-headed and unable to lead.

For those of us who voted for Donald Trump last November—many of us with some concern—we support him even more today than we did then. Though we occasionally recoil from the more outlandish, we have come to prefer reading his tweets more than we did reading about Clinton’s sexual harassment scandals. And we have learned to disregard the “Russian stuff” like so much “white noise” that rivals the sound of a tree falling in the middle of a forest for irrelevance.


Administrative State • Center for American Greatness • Congress • Conservatives • Healthcare • Obamacare • Republicans

‘Progressive’ Washington’s Obamacare Train Wreck

Here’s my problem: I’m a Bill of Rights guy in what’s become a Second Bill of Rights country. That’s why I can’t work up much of a pulse over the intramural healthcare debate among Senate Republicans.

The Democrats, the party of Obamacare and the dream of socialized medicine, has for Trump-deranged reasons become the Party of No on the matter of addressing the catastrophe they have wrought. So, the Senate debate, like the GOP-controlled House debate before it, is a family fight. The family is splitting up, though. The dynamic that led to Donald Trump’s election tells us why. The party no longer stands for what it has long purported to stand for: freedom, self-determination, and limited government. Nothing better illustrates this than its  Janus-faced approach to Obamacare.

Republicans, of course, have campaigned full-throatedly on the imperative to “repeal and replace” Obamacare for seven years. They’ve never been serious about it for a moment.

To be trendily trite, I’m old enough to remember when “repeal and replace” was deceptive because it understated the party establishment’s commitment to the GOP’s conservative base. In the beginning, Republicans boldly beat their chests and bellowed that they’d repeal Obamacare root-and-branch. “Repeal and replace” was actually the first moving of the goalpost, the first implicit admission that, in principle, they were all for a government-managed health-insurance system. If you really want to move to the free market, you repeal statism. When you’re talking “and replace,” you’re just haggling over the price.

In a few short years, “repeal and replace” has gone from a subtle understatement of what Republicans conned voters into believing they’d do, to a gross overstatement of what they’re willing to try. No one who has been paying attention can be surprised by this regression.

Obamacare has always been sleight-of-hand, on both sides. From the beginning, Democrats lied about its feasibility: “Like your doctor, keep your doctor,” “like your plan, keep your plan,” plunging premiums, lower costs, etc. All the while, they knew it was unworkable. That was not a flaw, it was the design. The plan was to orchestrate a collapse of the private insurance market, blame the private insurers rather than the death-spiral regulations, and gradually inure people to the need for a complete government takeover—the panacea of “single payer.”

Equally patent is that, at most, Republicans wanted to slow the train down, not stop it. Many of them, after all, have been on it from the get-go. “Repeal!” and, then, “repeal and replace” made for great fundraising and electoral wedge issues. But when it got down to brass tacks, it was always “Maybe the Supreme Court will strike it down,” or “Maybe we can sue Obama over these waivers,” or “Maybe it will collapse of its own weight.”

Republicans have controlled the House, where all spending originates, since 2010, and the Senate since 2014. Not a dime for Obamacare could have been spent had they not approved it. Never did they use the power of the purse as the Framers intended: Congress’s decisive check against ruinous policy.

That is because today’s Republicans do not see government as the Framers did—as a necessary evil that must be limited, its powers diffused so its tyrannical tendencies can be suppressed.

The modern GOP is the party of the Bushes, John McCain and Mitt Romney (the architect of Romneycare, Obamacare’s progenitor). These are fine, patriotic Americans, but limited government conservatives they are not.

“We have a responsibility,” President Bush proclaimed in 2003, “that when somebody hurts, government has got to move.” Government, in the modern GOP telling, is a force for good, not a necessary evil. You start thinking like that, it’s a short leap to convincing yourself that government can get everybody covered—not that the “coverage” would be a mirage and that statism would undermine the system of medical care.

Four years ago, the conservative crusade to defund Obamacare collapsed due to lack of GOP support—actually, due to surfeit of GOP derision. As unrealistic as the Republican establishment portrayed Senator Ted Cruz’s defunding strategy to be, at least it was a strategy— akin to a Hail Mary pass. The desperate aim was to kill Obamacare in the cradle, before its tentacles spread, making its reversal politically untenable.

By contrast, as I contended at the time, the GOP had no strategy to undo Obamacare because it had no intention of undoing Obamacare. To repeat just some of the reasons I outlined back then:

Remember, Republicans are the guys who gave us a new Medicare prescription-drug entitlement when Medicare was already tens of trillions of dollars in debt. They are the guys who ran in 2012 as the saviors of Medicare—even though they well knew that slamming Obama over taking money out of Medicare would make it much more difficult to address Medicare’s unsustainable costs in the future. They are the guys who accept core premises of Obamacare: Republicans do not make the case that health care is like any other commodity in a free market rather than a corporate asset to be centrally managed. The disagreement between statist Democrats and the GOP establishment is about the degree of government intrusion in health care, not the matter of government intrusion in principle. Republicans are also the guys who want to keep some of Obamacare’s core, anti-free-market elements—e.g., provisions that forbid denial of coverage owing to preexisting conditions and that keep “children” on their parents’ coverage until age 26.

The Democrats, the media, and all the Left will tirelessly portray any proposed repeal of Obamacare as a callous denial—a removal—of coverage from millions of underprivileged Americans, including those struggling with sickness. Moderates and “compassionate conservatives” already lecture us about the need to get real and make our peace with the welfare state; what will they be saying four or six or eight or who knows how many years from now? They will be arguing that Obamacare’s prodigious infrastructure is now part of our social fabric—that repealing it at this point (whenever that point happens) would be radical, the very antithesis of the Burkean conservative disposition. The GOP’s will to fight for repeal—which has never been as strong on action as it is on election-season rhetoric—will dissipate.

Well, here we are.

It was inevitable. After all, how many Republicans today would enthusiastically endorse Franklin Delano Roosevelt’s “Second Bill of Rights”? In Washington, nearly all of them, I’d wager.

As an up-and-coming “progressive” state senator, Barack Obama berated the Constitution as a “charter of negative liberties.” He was referring to the Bill of Rights, which says what government may not do to you—suppress your speech, deny your freedom of conscience, subject you to unreasonable search and seizure, take your life, liberty or property without due process of law, and so on.

Progressives, to the contrary, champion the Second Bill of Rights posited in FDR’s 1944 state of the union message. It is the wish-list of things government must do for you. It departs radically from liberty’s premise that the sovereign states and people do best when they do for themselves, with minimal interference from Washington. And it conveniently elides mention of the stubborn fact that government—which is a structure, not a guardian angel—lacks the means to do anything for anyone: It can only do for me if it takes from you.

Prominently included in the Second Bill of Rights is “The right to adequate medical care and the opportunity to achieve and enjoy good health.” It sounds wonderful—who would want to deny anyone the ability to seek health care? But even where rights were codified, they had never been understood to include the right to have other people pay for our enjoyment of them.

This is why the Second Bill of Rights has never been adopted, at least formally. It is, similarly, why the United States has never ratified the International Covenant on Economic, Social and Cultural Rights, which purports to guarantee “the right of everyone to the enjoyment of the highest attainable standard of physical and mental health,” by government’s “creation of conditions which would assure to all medical service and medical attention in the event of sickness.”

How many of today’s Republicans do you figure would dare publicly oppose the proposition that there is a right to medical care? If you’re using your hands to count and still have fingers to spare, it is a measure of how unserious we have become about actual healthcare.

Just as our fact-free, narrative-obsessed society has contorted the idea of a “right” into a subsidy, so too have we twisted opposition to federal control of a good or service into a desire to deny that good or service to others – naturally, because we are racist, sexist, ageist, and in the “intersectional” thrall of a -phobia catalogue.

It is simply a fact that centralized Washington control over health coverage, and thus of healthcare, is a disaster. It is unaffordable. It inevitably produces lousy medical outcomes. It drives costs ever higher. It incents the young and healthy to go without insurance, thus making coverage prohibitively expensive for the older and sicker. It stifles experimentation and innovation. It is unsustainable. And it is beyond tinkering here and a band-aid there because the cancer killing the patient is the government’s managerial role.

We do not have a major political party in this country that believes this enough both to say it and to act on it. We do not have a party willing to say that, in our system, health insurance and medical care are supposed to be left to market forces and regulation left to the states—which are best able to address the needs of their citizens. We do not have a party willing to insist that the way to achieve affordable, quality coverage while providing help to people who truly need it is best charted by 50 states free to compete, experiment and imitate; it will never come from Washington.

We need such a party. For now, we have Obamacare Democrats and Obama-lite Republicans—the express and the local, headed for the same train wreck.

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Administrative State • American Conservatism • Donald Trump • GOPe • Government Reform • Greatness Agenda • Healthcare • Obamacare • Political Parties • self-government • Trump White House

To Be Puritanical or Pragmatic on Healthcare Reform?

You’ve heard the spin coming from the Left and coming from some elements on the Right. The American Health Care Act (AHCA) is reviled by just about everyone. The Left hates it for the obvious partisan reasons and the Right hates it mainly out of an  understandable fear of being betrayed by our own Congressional leaders and their perceived weakness. To be sure, the bill that passed the House of Representatives left much to be desired. It is important, however, to keep in mind that the recalcitrant House Freedom Caucus ultimately voted for this bill. It cannot be all that bad.

I, for one, have never understood why we must repeal and replace an awful law, like the Affordable Care Act (ACA). In fact, I hate the entire idea of replacing Obamacare. Repeal and Replace was a talking point created by Republican strategists back in 2010 to get those much-ballyhooed moderates to swing their votes over to the Republicans. The logic was based on the flawed assumption that no American would ever support ending an entitlement. Many of us on the Right disagree with this bromide of conventional Beltway wisdom.

Yet we would all do well to remember that the bill that passed the House is not the final bill. Rest assured, it is during this iterative legislative process that our leaders will hammer out a much more workable bill. Now, I know what you’re thinking: that isn’t a good thing because it will give the politicians more time to equivocate and to hose We, the People.

What is likely at play is another classic Trump deal. In recent days, the Continuing Resolution now funding the government was extended until September of this year. The fear among the Congressional Republicans was that Trump would be intractable on the budget and a government shutdown would ensue. In the event that had occurred, Beltway Republicans argued that  the GOP would have been blamed for the shutdown and would have been at a disadvantage in the 2018 Midterms. Legislatively, Trump’s agenda would have ground to a halt. Whatever your opinion on this issue is, this is most assuredly what the Congressional GOP believed. Trump likely threw them a bone, giving them the budget that was least controversial—at least until September. In the meanwhile, he clears the legislative deck and allows the Republicans to focus on the prize: healthcare reform.

Whatever our problems may be with the House bill, we must remember that it rectifies the two big bugaboos the Right had with Obamacare: the GOP bill restores consumer choice and it lowers costs on the consumer. At the same time (and this is my problem with the bill), it purportedly appeals to those moderates—the great unwashed—who prefer to see a healthcare bill cover those pesky pre-existing conditions. What’s more, the House bill does this without the imposition of greater taxes on those who refuse to buy into the health insurance system.

This bill is not perfect. It may never be perfect. But, it is infinitely better than what the Democrats gave us. The goal here is to return as much freedom back as possible to the people. This bill already accomplishes that. And we have the ability to make it better.

Whatever does ultimately become law, Congress can tweak it later. But the core of what the Right has desired since Obamacare passed into law is protected. Freedom is the sine qua non of the United States. Choice and competition are essential components to maintaining freedom. Further, the removal of unnecessary and onerous taxes is vital for the preservation of America’s besieged middle class.

We are now moving the ball down the field and are heading toward the end zone. It is up to the GOP and the Trump Administration to make sure it’s a touchdown. In the ensuing days, it is up to every one of us to keep cheering them on to win this victory for us in the way we want it won.

As a former congressional staffer, I can tell you with certainty that elected officials listen to what their constituents say. Do not allow cynicism to get the better of you on this. Whatever pull lobbyists have (and they certainly do have pull); whatever other considerations our political leaders have, at the end of the day, most of them want to be loved by their voters. After all, if they don’t make a large enough group of their voters happy, they’re out of a job. And, believe me, most of our elected officials fear losing their jobs more than anything else.

So, call your senators. Call your congressmen. Call the White House. Send emails. Leave Facebook messages. Tweet your support for a bill that preserves choice, free market competition, and removes the need for more taxation. I guarantee you most of them will listen. It will at least move the needle in our direction. You can be sure that the Left will be doing the same on their end.

This healthcare repeal law is probably the biggest domestic policy issue facing us today. If the GOP cannot turn back the devouring leviathan that is the federal government; if Republicans cannot preserve choice and competition, while lowering taxes for the American people, then the country will be lost.

We could opt for the more obvious route of ideological puritanism. Honestly, I am very tempted to do this. We could throw our hands up and say that we’ve been hosed. Or, we can be pragmatic, and take the bitter with the better. We need to understand that we cannot have legislative victories on points of order for which we have not yet built popular support. We need to work on building that support and, as part of that, we should realize that nothing creates success like success. And, we need a win right now if we hope to persuade in the future. Trump’s legislative agenda needs some momentum. More important, we should see that this is not the end, but the beginning of an ongoing process to make American healthcare great again.

I’m not afraid of being partisan. I’m also willing to buck political orthodoxy (I was an early supporter of Trump, after all). However, I’m also willing to give people a chance—even our elected leaders. We’ve already gotten the core of what we wanted. Let’s not blow the whole thing up because there were some bad elements in there. We can work over time to make it better.

After all, the Left is just waiting for the GOP to self-destruct. Let’s not give them that opportunity. We can—and should—be pragmatic on this issue.



Government Reform • Healthcare • Obamacare • Section 1

Repeal Obamacare & Add a Side of Free Markets

When the misnamed Affordable Care Act passed into law in 2009, the GOP promised to repeal it. Finally, in 2016, the voters granted the Republican Party the majorities that it had long sought—as well as control of the White House. In keeping with their promise to overturn the ACA, the GOP focused their legislative agenda on first replacing Obamacare. And, it was a flop. A majority of Republicans cared little for replacing Obamacare. They simply wanted it gone. But, the GOP leadership convinced themselves that the American people wanted more than simple repeal.

You see, according to the thinking of most conventional elected Republicans, it is not enough simply to be opposed to something. Politicians also have to be for something! There is something to this in that voters expect politicians to know and understand their principles and priorities. But it is not always necessary for Republicans to offer a policy just because Democrats have offered one on a subject. Sometimes the best policy can be no policy at all. But too many Republicans believe that once an entitlement takes hold it is impossible to get rid of it. The people would punish the party that dared try to do so.

The Beltway Logic is wrong. Sometimes simply being opposed to a bad idea is more than enough.

But, the Captains of the Conventional Wisdom who command Conservatism, Inc. would press on and say, “we can’t just be the party of ‘no.’” So, they’d rather us be the party of “yes, but…” After all, it’s bad symbolism to simply be opposed to something. As George Carlin would say, let’s leave symbols to the symbol-minded. In all of this talk about replacing Obamacare and Free Markets, we miss the entire point: average folks in America are getting squeezed by the ACA. What’s more, the ACA is set to implode under its own weight very soon, meaning that many more Americans are likely to suffer as they are left without any kind of health insurance whatsoever. And, since the Trump Administration has indicated that healthcare reform is now dead, many more Americans will suffer when the ACA does finally collapse.

Medical caregivers are required to take the Hippocratic Oath which states, “First, Do No Harm.” Similarly, lawmakers should craft laws that do the least amount of harm to the American people as possible. A repeal and replace concept, while it made for fanciful sloganeering, was the worst possible way to go. If what Ben Franklin said about politics being the “art of the possible” is true, then repealing and replacing is simply impossible. It’s one or the other. Especially in today’s toxic partisan atmosphere.

Further, the American people want their healthcare costs to go down. The GOP has maintained that its aim was to lower healthcare costs on most Americans. Repealing the ACA, which caused health insurance premiums to skyrocket would have fulfilled the GOP’s goal nicely. It was also something a majority of Republicans could get behind. What’s more, had Congressional Republicans focused on removing interstate barriers to the health insurance trade, they would have drastically lowered healthcare costs for most Americans. By neither repealing Obamacare outright nor removing the barriers to interstate health insurance trade, the Republicans have betrayed their supporters.

Plus, the bill they were working on passing was shaping up to be one of the most complex, massive bills in history.

When I worked in Congress, we passed the “Read the Bills Act.” Put simply, this was a law that required Congressmen to actually be given a reasonable amount of time to read and understand the bills that Congress voted on (before those bills were enacted into law). Talk about a novel concept! This was in the aftermath of Nancy Pelosi’s mind-boggling statement that Congress had to pass the gargantuan Affordable Care Act “to know what was in it.” On top of failing to reduce healthcare costs, then, the Ryancare bill (Obamacare Lite, as many rightly described it as) defied the spirit of the Read the Bills Act. It was all around bad governance.

In crafting something so complex (and by demanding that Congress vote on it in such short order), Paul Ryan essentially did the very thing that earned such justly deserved opprobrium for Nancy Pelosi seven years prior. Ryancare was the result of Washingtonian “wisdom” getting the better of our elected leaders. It was also a case example of why the Trump Administration cannot rely on Congressional Republicans for much in terms of crafting legislation. Frankly, there are too many divisions among Congressional Republicans. The Ryancare bill was not what Mr. Trump had campaigned on. Next time, President Trump should remember that politics is the art of the possible and it is impossible to get Congress to pass a law as controversial and complex as the Ryancare proposal was.

So, next time, Mr. President: we’ll take the repeal of Obamacare, with a side of the Free Market—but hold the replacement.


Administrative State • America • American Conservatism • Big Media • Center for American Greatness • Congress • Conservatives • Democrats • Donald Trump • GOPe • Government Reform • Greatness Agenda • Healthcare • Obamacare • Republicans • The Left • The Leviathian State • The Media • The Resistance (Snicker) • Trump White House

The Art of the Possible in an Age of Recrimination


As Otto von Bismarck several times had occasion to observe, “Politics is the art of the possible.” On at least one occasion he added, “the attainable—the art of the next best.”

Since, as Henry Kissinger once observed in a long essay on Bismarck, the Prussian colossus was a “revolutionary” who sought not to “adapt [his] purposes to reality” but rather “to mold reality” according to his purposes, the boundaries of the possible were for him a fluid if nevertheless calculable restraint.

I thought about Bismarck more than once these last few days, as I watched the chihuahuas go at it following the failure of the RyanCare™ bill in Congress. Here are some of the headlines at RealClearPolitics on Sunday morning:


  • Ryan Emerges Badly Damaged
  • Dismantling Obamacare Little More Than Campaign Rhetoric From GOP
  • DC’s Blame Game, Finger-Pointing
  • Long Knives Out for Reince
  • Trump and Ryan Lose Big
  • Party Unready to Govern
  • How Trump Botched Health Reform

And possibly my favorite:

  • GOP Cave on Repeal, The Biggest Broken Promise in History

In history, Kemo Sabe: the biggest broken promise in history.

Meanwhile, back on earth, in the realm of actual possibilities, Donald Trump seems perfectly calm and matter-of-fact. He had always said, over and over, that the politically expedient thing for him to do was sit back and let ObamaCare™ implode on its own and then swoop in and, when people were desperate and the Democrats were busy trying to prise the large omelette off their collective countenance, engineer a fix.

Trump didn’t do that, as he also said repeatedly, because he had promised to “repeal and replace” ObamaCare™ as soon as possible. So he turned to the Republican lawmakers right off the bat, just a few weeks into his administration, and said: What have you got for me?

Different people calculate political possibilities in different and more or less effective ways. On Thursday, March 23, the jury was still out on Paul Ryan. By late afternoon Friday, the jury had reassembled and delivered its verdict. Bad show.

Why wasn’t Trump more upset about this? The chihuahuas were barking their heads off—Republicans can’t govern! Woof!—Trump is a loser! Woof Woof!—Trump’s entire agenda is in shambles! Woof Woof Woof! But there he was, Mr. Imperturbability: We were very close, Paul Ryan worked very hard, we’ll let it implode and come back to sweep up the pieces when the Democrats are ready to negotiate.

Who’s the fall guy? Well, Paul Ryan is not looking so great. The rap: You had seven years to work on this, why couldn’t you come up with a bill that all Republicans, at least, could support? There might be excellent answers to that question. But at times like this interrogatories are not meant to be answered: they are hurled as political hand grenades. No answer is expected. Just humiliation, followed closely by impotence and capitulation.

The chihuahuas of the fourth estate are desperately endeavoring to tar Trump with the same brush. So far it is not working. Why not?

Perhaps the most compelling answer to this question that I have seen comes not from the congregation of chihuahuas but from a lowly cartoonist, albeit one who also happens to be a sort of genius about politics.

I mean Scott Adams, the creator of the “Dilbert” comic strip and also the person who had the best analysis of the truly insane “Trump-is-Hitler” meme that was sweeping the country until Friday. According to Adams, what people were reacting to was not Donald Trump but a malevolent hallucination of their own manufacture that they pretended was Trump. “As Trump continues to defy all predictions from his critics,” Adams observed back on November 23, “the critics need to maintain their self-images as the smart ones who saw this new Hitler coming. And that means you will see hallucinations like you have never seen. It will be epic.” He elaborated:

Before Trump won the presidency everyone was free to imagine the future they expected. But as Trump continues to do one reasonable thing after another, his critics have a tough choice. They can either…

1. Reinterpret their self-images from wise to clueless.
2. Generate an even stronger hallucination. . .

If Trump’s critics take the second option—and most of them will—it means you will see a lot of pretzel-logic of the type that is necessary hold onto the illusion that Trump is still a monster despite continuing evidence to the contrary.

Adams was clearly right about that. And I believe he will be proved right about his next prediction—actually, his next two predictions. With his usual amusing understatement, Adams described the failure of the Republican health care bill as “one of the most important events in political history.” Why? Because with that very public failure “the illusion of Trump-is-Hitler” has been repealed and replaced. Until Friday afternoon, the Trump-is-Hitler meme was chugging along. Then, poof, it suddenly imploded in the face of a tasty new meme: Trump-is-incompetent (pass it on)!

You might say, “Wait a minute! That’s not so good. We don’t want an incompetent president.”

No, we don’t (and don’t worry, we don’t have one—not currently). But Adams’ point is this: “Trump just had one of the best days any president ever had: He got promoted from Hitler to incompetent.”

Not bad for an afternoon’s work. And it will be followed, Adams predicts (and I concur) with an antistrophe: “By year end, you will see a second turn, from incompetent to ‘Competent, but we don’t like it.’”

Of course you don’t. Trump just authorized the Keystone Pipeline. A week or two back he issued an executive order to revamp the entire executive branch, eliminating duplicative or unnecessary program and positions. He is moving fast to enforce our immigration laws. He has already issued executive orders to pare back onerous and unnecessary regulations. At the Pentagon, Secretary of Defense James Mattis has set about rebuilding America’s military, pursuant another of Trump’s executive orders. And on and on. He is keeping his campaign promises to Make America Great Again. How dare he!

No, the “Trump = Incompetent” meme is not going to last very long. But Adams is right: what it replaces was, though hallucinatory, extremely toxic. Here and abroad the hallucination “Trump-is-Hitler” made the usual business of politics very difficult. A crisis of legitimacy loomed. But all that is suddenly behind us now. In other words, “We just went from an extraordinary risk (Trump=Hitler) to ordinary politics (The other side=incompetent). Ordinary politics won’t spark a revolution or make you punch a coworker.”

The chihuahuas are barking but the caravan moves on. “This,” as Adams concludes, “is a good day for all of us.”


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GOPe • Healthcare • Obamacare • Republicans

Ryancare Will Destroy The Republican Majority

Failing to repeal Obamacare would be “the ultimate betrayal of the electorate.” That’s what Charles Krauthammer said just last month. He was right. Congressional Republicans have been defined by nothing so much as their opposition to Obamacare since 2009. That opposition has been the source of four successful elections that have seen Republicans gain 62 seats in the House, 12 seats in the Senate, and now control of the White House.

Given the dubious circumstances surrounding the passage of Obamacare in 2010, it should be no surprise that resistance to its mandates has proved so durable. Throughout the entire debate in 2009 and 2010 the legislation was wildly unpopular. So eager was Obama to pass the bill it required shady deals like the infamous “Cornhusker Kickback,” false promises (“if you like your doctor you can keep your doctor”), and playing games with House rules to pass it under the reconciliation procedure reserved for tax measures. Even after all that, 34 Democrats joined every House Republican in voting against the bill. The story was the same in the Senate where not a single Republican voted for Obamacare.

Still, the healthcare bill offered by Speaker of the House Paul Ryan (R-Wis.) seems like a premeditated act of defiance against the expressed desires of his own base. And it is an obvious contradiction of Ryan’s own rhetoric.

For seven years Republicans have campaigned against Obamacare. They’ve recited its manifold deficiencies and depredations so many times that voters know them by heart: It imposes an unworkable and morally objectionable requirement on Americans to buy health insurance whether they want it or not, it raises costs, reduces choice, and leads to rationing.

All of these things are true and ordinary Americans have felt the consequences. Premiums have skyrocketed, people have lost coverage, businesses have closed as a result of the Obamacare mandates, the exchanges have gone bankrupt, and insurance companies still haven’t figured out how to make money in the individual market. Through it all the Republicans have promised to repeal “the government takeover of healthcare” if only voters would give them power.

And they did. Voters provided the money and the votes to give Republicans the power they said they needed to repeal Obamacare. Hundreds of millions of dollars flowed into Republican coffers. The 2010 midterm elections were an historic rebuke to the Democrats as a direct result of their Obamacare votes. But that wasn’t enough. Republican leaders testified repeatedly that they wanted to repeal Obamacare and surely they would if only they controlled the Senate. Then Speaker John Boehner (R-Ohio) liked to remind impatient voters that Republicans only “controlled one-half of one-third of the government.”

In 2014 voters gave Republicans what they said they needed—control of the Senate. But with that victory still fresh, Senate Majority Leader Mitch McConnell (R-Ky.) said even that wasn’t enough. He wanted to repeal Obamacare but his hands were tied—the president would surely veto any such legislation. What they needed was a Republican president. And in 2016 they got one. Now voters want the Obamacare repeal they have been promised. But Ryan’s healthcare bill does no such thing.

Warning signs were everywhere as soon as Congress got back to Washington. As early as January, Rep. Raul Labrador (R-Idaho) told The Hill, “I’m hearing a lot of members say that they want Obamacare-lite. That’s not what we promised the American people.”

No it’s not, but that’s what Paul Ryan has proposed. His bill leaves the infrastructure of Obamacare in place and creates a massive new federal healthcare entitlement program in the form of refundable tax credits. These credits are just camouflage for government checks to buy health insurance. They are unwise and unaffordable in their infancy under the Ryan plan but everyone knows the size and scope of the program will only grow over time.

The Republican leadership thinks that their half-measures and clever branding are a sign of moderation and prudence but they are courting disaster. They apparently learned nothing about the fury of scorned voters during the last election.

President Trump has signaled support for the Ryan plan but he has also been cagey in his wording and if it heads south he can be expected to blame Congress. Wavering legislators tempted to support the Ryan plan should recall that Barack Obama promised congressional Democrats that he had their back in 2010 before watching them lose 62 seats in the House.

The issue is simple—perhaps too simple for Washington: people want Obamacare repealed. The fact is that whatever its shortcomings (and there were many), American health care was better before Obamacare than it is today. Prices were lower, deductibles were lower, and there were more and better choices for both insurance and care.

Donald Trump promised to restore the good things about the pre-Obamacare system and to enact some common sense reforms. A week before the November election he said, “If we don’t repeal and replace Obamacare, we will destroy American health care forever—it’s one of the single most important reasons why we must win on November 8. Our replacement plan includes Health Savings Accounts, a nationwide insurance market where you can purchase across state lines, and letting states manage Medicaid dollars.”

But that is not the Ryan plan.

There are no Health Savings Accounts, no nationwide insurance market, and even the Medicaid promise is suspect. When Republican voters heard repeal and replace they thought they were getting HSAs and the ability to buy insurance across state lines. What they’re getting is expanded Medicaid and a budget busting new entitlement program. That wasn’t the deal.

Whatever support President Trump has shown this bill it will be congressional Republicans who pay the price for supporting it. They will face the wrath of the base for turning their backs on the oft-repeated promise to repeal Obamacare. They’ve raised untold millions on the back of that promise. They’ve won election after election because voters were willing to trust—or at least take a chance—on that promise.

Having found a sure political winner, Republicans seem intent on snatching defeat from the jaws of victory. If they pass the bill currently under consideration they will own the healthcare disaster that, until now, had Barack Obama’s name on it. And they will have betrayed the people who put them in office just months after returning to Washington.

Republican legislators eager to just pass something and claim victory would be wise to remember that their base agrees with former Louisiana Governor Bobby Jindal: “Republicans who want to retreat from repeal to repair should be replaced.”