Ever since ACA (AKA Obamacare) passed, I thought it was a bad idea. Like trying to polish a turd. It seems to me that the insurance companies are why healthcare in the US is more expensive than elsewhere and playing into their hand is unlikely to fix it.
Second, politics is weird (as yesterday showed). So many times the opposite of what you think will happen is what happens.
So, in that vein, I predict that under the Trump administration we will see the US adopt a single-payer (government-funded) healthcare system that will cover 100% of the US citizens. I think Trump and the Republican Congress will try to repeal ACA but find it a tough sell without anything to replace it with (and you can bet the insurance companies aren’t going to go backwards and accept fewer people insured). Add to this the fact that it will be obvious that it just makes good business sense to take the insurance companies’ cut of the action and use it to pay for the increased costs. Big business will be in favor since it will relieve them from the uncertainty of increasing insurance costs. It will end up being up a big win all around and the only reason the Democrats won’t like it is that it came from Trump.
Finally, I think it would be a great way of helping to mend this great divide the two major political parties have created in this country.
I can see it in one situation. If the Republicans decide that by having single payer health care with no legal private insurance they can control what medical procedures are available. Thus they could use it to make abortion, sex reassignment, and any other procedures they don’t like de facto illegal.
There’s no chance of Trump signing a single-payer insurance bill.
The Republicans will talk a big game. They’ll repeal ACA. They’ll futz around with different ideas, but will end up enacting something that will have most of the elements in the ACA, but with Republican spin on how it’s better than Obamacare.
That’s like saying auto insurance companies make repairing cars more expensive. Insurance companies simply spread the costs around. They take a cut, but I’ve seen no evidence that’s what has and is causing higher healthcare costs.
Presidents don’t get to do that. If they are so inclined, they can propose a health care measure, which will get beaten to death in committee, and then either fail or get passed in some altered form acceptable to the majorityin Congress… And then name it after (and blame it on) the president, who had little to do with it.
Which is why “Obamacare” is the piece of shit that it is. It’s a perfect Republican vehicle, which forces every American to buy a product they might not want from the for-profit sector…
Trump lives for revenge, and single payer would be a giant, Fuck you! to all the Republican establishment and punditocracy that have tried to exclude him and belittle him.
It also establishes Trump as a game changer, right out of the gate. “No one could do this but me, Trump!” Hilary tried, failed. Obama tried, failed again. More revenge, and he gets to say, “I told you so!” Not to mention effusive praise from the “liberal media”.
Currently, Trump can do no wrong in the eyes of the white working class. He has the power, no Pubbies dare stand against him. Only Nixon could go to China; only Trump can launch Single Payer.
If he wants to really do something about bringing jobs back to the rust belt, he going to need support from liberals in Congress. It could get interesting. Of course it’s probably more likely he does nothing and a good chunk of the voters who swept him into the office realize they’ve been had.
I think it’s a possibility. A key quote from Trump’s victory speech:
So, it’s been what they call a historic event, but to be really historic, we have to do a great job. And I promise you that I will not let you down. We will do a great job. We will do a great job.
I think his ego wants to do “great things,” and he truly doesn’t care if those things match the GOP agenda or not.
He will probably end up doing a few extremely Progressive things on accident.
To extend my earlier remarks: What does Trump want more than anything else? Respect. To be seen by the Pubs, the Dems, the professional operatives and the chattering classes as a real player, not a clown or dilettante.
Ram Single Payer through Congress, and he makes history.
What is Trump good at? Not conventional politics, that’s for sure. Not government, that’s for damn sure. Has certainly never read the Constitution. Doesn’t know the branches. Doesn’t know the departments, how they’re set up, or what they do.
What does he know? Backroom deals. Arm twisting, horse trading. He’s been doing that with local, state, and Federal officials, not to mention union bosses and their, uh, associates, his entire adult life. Bankers, investors, lawyers, same thing. Been dealing with reptiles in Brooks Brothers suits since he was a skinny young’un.
Given what we’ve seen of him, on video and by testimony of multiple women, he wouldn’t have a problem serving up some hot, young crumpet for a reluctant Senator to seal the deal.
Trump is a skilled liar, and very high functioning sociopath. He is ready, willing, and able to betray mainstream Republicans at the first opportunity to make himself look good.
Trump has already introduced his support for Single Payer. He did it in a low-key, just- testing- the- waters kind of way during the Republican primaries.
Now that the idea has been floated, it won’t seem so radical when he re-introduces it in a big way. What’s the difference? Now Trump has the support of a massive white working class constituency.
They have bought in to Trump in a big way, and will now follow wherever he leads them. First, they buy in to Trump, then they buy into his ideas. Not buying into Single Payer would force Trump supporters to repudiate someone they’ve invested their trust and self-identity in.
This is a persuasion technique. First you buy into the salesman, the persuader. Then you buy into what he’s selling. Old as time itself.
This is also why Obama could never get traction with the same ideas. He couldn’t get Trump-Americans to buy into him. They’re deeply, instinctively hostile to people who violate America’s historic caste taboo against African-European intermarriage.
As much as I hate to admit it, Scott Adams was right. This is all calculated.
If Trump manages to enact federally mandated single-payer healthcare, funded out of general taxation, I think I might actually forgive him. It must surely happen anyway eventually, because it’s the only sensible way to run a healthcare system, but it could otherwise take 30 years and the complete disintegration of everything else first. Healthcare is so politicized that the only way I can really see it happening is slowly, state-by-state, with empirical evidence that it works well at a state level eventually overriding partisan politics. If Trump can leverage his current popularity and arrogance to short-circuit that and enact it right away, over the dead bodies of a Republican Congress, I swear I will forgive him all the other horrendous stuff. The benefit would be so great to so many people - it could literally save thousands of lives every year, and improve quality of life for millions. I would wear a Trump baseball cap with pride; ok, with an asterisk maybe.
There’s an outside chance that he’d be able to get the plan through, but it would require so much arm twisting of the necessary House republicans that financially it would end up like Medicare Part D, i.e. not paid for. Assuming Colorado’s Prop 69 was roughly accurate for the nation as a whole, no Republican member of congress would even consider a 10% increase in the tax rate (Grover be praised), so what would end up happening would be that there would be a much more modest increase in taxes and the deficit would skyrocket making the increase during the Bush and Obama years look like a car loan (especially once you add in the tax cuts he’s already promised.)
There is no chance now of a straight up repeal of the ACA, the dems in the senate will never allow it. I do think that now, unlike before, they will be willing to discuss modifying it. Considering the recent rate hikes and other issues that have formed around it I can see them trying to “fix” it. Fixing it at this point may very well take them down the path to single payer.
Those of you who haven’t really been paying attention haven’t realized how strong of a persuader Trump is and I can see him modifying the public opinion into going down the single payer path in a way that Hillary never could have. Then Trump will build a lot of good will among those who hate him today and have a built in legacy.
