55 Comments
Nov 21Liked by Jeff Maurer

“The right wants stuff that would be enormously unpopular if it happened, but they’re terrified of their base, so they might choose to simply pass the Carnage And Mayhem Act Of 2025 instead of taking a stand.” I think you could replace “right” with “left” and this sentence would be equally true. And that’s one of the biggest problem with modern politics.

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Yes! I noticed the same thing! Though I do think that Democrats have a better record of saying "we'll form a committee to study that!" and then quietly letting the bad idea die.

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The difference is that the left really does not run the Democratic party. The base of the Democratic party is its suburban anti-radicals.

The Republican party used to be like this too (indeed, I think I would have said it was more so) but now it ... isn't.

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I would be more inclined to agree with you had almost every sub-group of that base not shifted to the Republican side this election. The urban lower middle class is not fleeing from the tyranny of suburban anti-radicals.

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I’m saying that I think people often misunderstand what the Democratic base is. Base doesn’t mean “your most ideological voters” it means “your most consistent voters”.

It wasn’t middle aged white suburban liberals who broke against Democrats in this election.

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But to your original point, the base doesn't always run the party, sometimes *because* they are the most consistent voters and therefore can be taken for granted (or at least perceived that way).

When we look at how the Dems have prioritized and messaged over the past ~decade, it seems to difficult to conclude that the left isn't the tail that wags the dog.

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It's a great point in general, but I totally disagree with the conclusion at the end.

I think the left has lost every major internal battle since I started voting. But they also punch above their weight. I think both things are true.

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What are the major battles that the left lost *internally* over the past decade--in the sense of failing to push the party's agenda to the left--as opposed to those that the entire party lost externally after allowing the agenda to move?

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I use Obamacare and am glad we have it, but it is in need of massive reform. The "marketplace" is kind of a joke. Where I live, you really don't have much choice other than Blue Cross Blue Shield because the health care networks won't take anything else. There are like nine combinations of BCBS plans that all add up to the same amount of spend (you either pay higher premiums or higher deductibles). So, the promise of competition driving down costs was a pipe dream that never materialized. The whole subsidy thing is confusing and hokey. You have to predict how much you will earn the next year, which is easy to do if you have a job with a regular paycheck. But, most of those come with employer coverage. Beefing up Medicaid (raising the income level to cover Uber drivers, pay the providers more so the recipients can get better care) instead of the subsidies would be better. Opening up Medicare to early retirees for a fee would be better, too. Then, what's left is an insurance pool for regular working people who don't have access to employer plans. The existing ACA marketplace is pretty much designed to do this. Costs would go down because the subsidized and the semi-elderly would be removed from the pool. So, if this is the kind of common sense types of reforms they are thinking about then please have at it.

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> Beefing up Medicaid (raising the income level to cover Uber drivers,

My proposal is to just get rid of the income cap, entirely. Let any American citizen tap a few clicks on their phone and they're now covered under Medicaid.

Yes, the coverage ain't great. But it's a floor, and does cover a bunch of things that could cause people to spiral if they aren't taken care of. And you don't need to "prove" you're poor.

Will middle-class people with jobs want it? No. But if they're suddenly laid off, they don't need to wait until they're destitute to get their insulin or that cavity filled or that cataract dealt with, and when they get a job they go back to their normal coverage.

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"Medicaid for All" seems like it would obviously become the proverbial camel's nose for "Medicare for All."

Which may well be a feature rather than bug, but is going to make the proposal a lot more controversial than you've framed it.

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I'd call it "Medicaid for Any" or "Medicaid on Demand" since you aren't forced on it, but I agree about the optics.

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Have you ever had state funded insurance aka "Obamacare"? I grew up on "Hoosier healthwise" and as an adult small business owner tried Obamacare for a year but gave up bc even as a healthy young adult with zero preexisting conditions, and making very little income initially the cost was absolutely outrageous and the deductible was astronomically high (one no normal healthy person could ever manage unless you get one surgery a year.) Half of my loved ones are still dealing with our bullshit healthcare system like my mom and my 90 year old grandma whose only income is social security but somehow makes too much money ($2100 a month) so is forced to do some some weird partial plan. My point is: our system needs reform and you are doing no one any favors if you fail to understand how these programs work on the ground and the ways they could easily be improved. They is a tremendous amount of waste in our system and it would be one thing if everyone was getting the care they needed but they are not. Not even close. So if I get a choice ima take the tax break and pay entirely out of pocket which is what many end up doing bc it's cheaper instead of depending on a bunch of smart people with spreadsheets telling me how "essential" this is-thanks but no thanks.

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Paying for health care completely out of pocket is cheaper when you're healthy, but if you get sick, that suddenly becomes extremely untrue.

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American healthcare is fascinating from my French perspective. We are at the opposite end of the spectrum. Our social programs are something like 130% of state budget (not a typo, social spending is counted separately) and 30% of my salary automatically goes to financing it - that's just for social taxes, it doesn't count the income tax, which is applied on the remaining 70%. I'm 35. But if someone has to go the hospital, that's entirely free for however long he has to stay, and we all sleep better for it.

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Nov 21·edited Nov 21

I don't see how this is so different as you seem to think it is... If I spent 30% of my salary on health insurance, I would also be able to go to the hospital for "free".

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Nov 21·edited Nov 21

You don't see much difference between the American system and a system where 30% of every salary paid in the country goes, by law, to Social Security?...

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Sure, you're right, I see a lot of difference.

But my point is that in this narrow way it's not so dissimilar: If we spent 30% of our salary on health insurance premiums in the US, for most of us, that could buy us a plan that does not requiring paying at time of service.

We mostly choose not to do that, because most people spend less than 30% of their salary on health care in most years. So by paying less in premiums and more at time of service, we come out ahead, compared to this particular counterfactual.

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Which has been true since the Ancient Greeks were starting to stack stones on top of the Parthenon. The PPACA was sold s a set of solutions to the existence of reality itself (you can get insurance for a preexisting health problem, try doing that with car insurance) and delivered on none of the core ones. The plans on offer are also subsidized so it didn't lower costs for anyone as much as it did pass them along to other people, either taxpayers or health companies, who have responded exactly as predicted by lower quality and stretching overtaxed systems farther and farther.

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> even as a healthy young adult with zero preexisting conditions

You have this expectation backwards. Health insurance is by design very expensive relative to its value, for exactly this description of person.

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I mean. I know it’s funny, but of all the things to doubt about McCain, whether or not he was a courageous man is really, really, not one of them.

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The article you linked claiming Republicans want to cut Medicare is actually referring to Medicaid, and the Republican plan involves adding a “responsible and reasonable work requirement” for Medicaid benefits resembling the one that already exists for food stamps could yield about $100 billion in savings. He also said another $160 billion in reduced costs could come from checking Medicaid eligibility more than once per year."

So it's about fraud and abuse reduction, not cuts into bone.

Additionally the X about cutting veteran's health is maximalist ridiculousness. Both that Xer and you are pulling the "parade of the bleeding stumps" trick here:

"This unsavory phrase originates in British government bureaucracy and darkly refers to the Civil Service's clever response to the threat of spending cuts. The idea is that whenever cuts in a department are demanded by elected ministers, civil service bureaucrats respond by ignoring the many cases of waste, inefficiency, or general uselessness in the department, and instead tell the minister that the only way to cut spending is to axe necessary or politically important services and initiatives. So for example, when a government minister demands cuts to a hospital, the bureaucrats hide the two hundred administrators in a back room and haul out the battered and bruised hospital patients (aka the "bleeding stumps") to show the minister "who will be hurt most by spending cuts." The hope is that the minister will then back down, realizing that cutting funding would be politically unfeasible."

https://www.americanthinker.com/articles/2010/07/the_parade_of_bleeding_stumps.html

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Nov 21·edited Nov 21Author

Whoops, that's a pretty bad typo on my part -- I did mean Medicaid, not Medicare. It's fixed. We'll debate the wisdom of a work requirement for Medicaid some other time -- health insurance is really the one thing I want people to have no matter what, because when people don't have it, it doesn't save money, it just shifts money around.

I think the hit about Ramaswamy calling for cutting veterans' health care is fair because, true, he didn't say "I want to cut veterans' health care", but he suggested that expired authorizations are wasteful spending that can easily be cut, and veterans' health care is an expired authorization. To my knowledge, he hasn't backed down from that talking point. So, he's still going around saying "Why are we wasting money on this expired stuff?" without acknowledging that the expired stuff includes veterans' care (and other stuff that no sane person would eliminate!).

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Thanks - I agree our health insurance system is completely broken. The decoupling of payment from consumption leads to overconsumption. But of course the health insurance companies like it that way. I am not a fan of single payer because it has other problems, but something needs to change.

As for the expired authorizations: if they're really that important, Congress should act to re-authorize.

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Perhaps the debate about single payer will roll around again in, oh...2040 perhaps. I hope to be long dead by then. And as far as authorizations go, my point is simply that veterans' health care (and other stuff) isn't wasted money just because the authorization has expired, and Ramaswamy shouldn't run around pretending like it is.

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Vivek's entire existence is running around pretending that he knows stuff, fwiw.

Honestly, there's a lot of hay to be made in reforming veteran disability rather than health care. Although my VA medical care is very generous, disability payments are where the real fraud, waste, and abuse happens. But the public doesn't have the ability for that nuance, and the means to express that def isn't coming from Vivek.

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Nov 21·edited Nov 21

Let's accept your stance "veterans' health care (and other stuff) isn't wasted money just because the authorization has expired".

Do you apply that same logic for your in-app subscriptions? To car insurance after you've switched providers? That Hustler channel subscription you "accidentally" purchased back in your teens? Can they all keep providing (what they deem) non-wasteful services to be paid for?

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I think probably not, because those trivialities seem like very different things than providing healthcare to people who have fought in wars for our nation?

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Nov 22·edited Nov 22

Respectfully, you've made the same mistake I was trying to point out to Jeff. You've taken my analogy as a values/morals (you say "trivialities") statement rather than a process statement.

The process is whether something is authorized, Yes or No. If No, then it doesn't matter if it would end world hunger tomorrow. It isn't authorized, and therefore should not be spent on. Period.

The risk you run is having people who don't agree with you believe that their causes (opinions, priorities, whatever) also don't need authorization because they know it is a "good" thing just as much as you know veterans health care is a "good" thing.

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It would not be the first time that someone painted themselves into a corner with tough-guy posturing and then was forced to follow through on some stupid promise or threat just to save face.

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They should use the filibuster on themselves lol or just do that Onion thing where they move really slow so they dont have to pass anything

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I know it's a throwaway line, but no, liberals were not high on the Musk supply in 2017. You have to go back further than that to find a time when liberals actively liked Musk. But in 2017, he was merely tolerable enough to not outweigh the popularity of the cars his company was making. That level of tolerability is what has flipped since then. (Also there is much stronger competition in the EV market now!)

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On tariffs, confirming Matt Gaetz, etc., it seems absolutely certain that many Republicans think Trump is trying to do things they think are bad ideas.

But why assume that many Republicans thought killing Obamacare and cutting Medicaid were bad things? These are things Republicans have traditionally believed in.

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Because I remember it happening -- some Republicans were true believers, but many knew there would be hell to pay if millions of people suddenly lost their insurance and wanted the bill to fail. This was clear at the time -- it's why they kept scaling it back and back and back until they got to the "skinny" repeal, which is what McCain and two other Republicans finally killed.

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Unbelievable that this was the republicans’ plan all along and the democrats couldn’t successfully run against it.

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Nov 21·edited Nov 21

It was impossible to convince anybody that Trump was going to do the things he said over and over again that he was planning to do. I think I even had one or two of those conversations here.

People got so mad about inflation that they just turned their brains off. A lot of those people are gonna be pissed when Trump starts actually doing things.

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I felt the same way after Dobbs when so many people were “shocked” that abortion was actually illegal— it had been in the fucking GOP platform for decades!

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Dobbs did not make abortion illegal. It returned the decision to the States to decide through legislation - which is the truly democratic solution.

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And then a number of those states made it illegal. The parent comment is totally accurate.

I actually do agree that I prefer a democratic solution to this. But a national law would also be democratic, and in my opinion, preferable. I fully expect both parties to work on passing a national law, and I expect one of them to succeed at some point. It will be interesting to see what happens after that. Will the first law be an overreach? Will the first backlash be an overreach in the other direction? Will the Supreme Court decide that any national law is unconstitutional? But I feel certain that the current "it's up to the states" approach is an unstable equilibrium that won't hold.

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Thank you MajorPedantic but indeed it is illegal now in many states.

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Nov 22·edited Nov 22

Look, I'm not on Team Blue or Team Red, I'm on Team Constitution. And it's as important to me to understand civics as it is to Jeff to understand economics. Misrepresenting what a SCOTUS decision did or didn't do is misplacing the blame for the problem. If people don't like what Texas or Indiana do with their laws regarding abortion, maybe they should have passed Roe-level abortion protection into federal law when they had the chance.

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I totally agree with you on the principle here, but you really are being pedantic here, which makes the argument you're trying to make less credible than it should be.

The comment you replied to said "after Dobbs when so many people were “shocked” that abortion was actually illegal", and it is true that "after Dobbs" it is the case that "abortion [is] actually illegal" in a number of states. The comment did not say "Dobbs directly outlawed abortion", which I agree with you, would have been a misrepresentation. But that's not what it says.

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I must have missed something - what has Trump actually done? "Calling for" and "actually doing" are two very different things.

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He has announced a number of appointments and started providing details on some of his plans. It's obviously too early to talk about things he's done in the past tense, but it's not too early to discuss what actions he is planning to take, because those plans are beginning to clarify.

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Ironic that Obamacare itself was motivated by Ted Kennedy having brain cancer.

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Umm, no one's calling out that the "putting a team together” thing is from Seven Samurai originally, not Ocean’s Eleven?!?

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Of course, the Americans witnessed the most severe glioblastoma during the reign of Dems in the White House, turning it into a horrible slaughterhouse by their president - insane, inhumane, barbaric, Irish Catholic Biden the brute. For the entire four years, what he did was - total massacres, butchering, incinerating men, women, children, infants, and mothers breast-suckling babies, while sending shiploads of lethal armaments to forcibly occupied territories of Palestine by naked European savages. With every lethal armament shipment, to hoodwink and cheat the world, he sent his peace envoy, namely, the Secretary of State. The results? Over 43,000 Palestinians were slaughtered alive in Palestine, in their historical motherland, by helicopter gunships, fast fighter jets, aerial bombing nonstop 1000 mega-ton bombs, and using artillery fire by heavy war tanks. All this was done - cocaine pulling, Biden murmuring - towards Trump, "No one is above the law!"

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Democrats can only dream of such party discipline that one of their Senators would agree to contract brain cancer for political gain.

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The late P.J. O'Rourke made what I think is the best epigram of the late 20th century: "“If you think health care is expensive now, wait until you see what it costs when it's free.” It's a great epigram because it is brief, punchy, surprising, funny and wrong.

In fact, every country where health care is "free" spends less on it as a fraction of GDP than does the US. There are various reasons for this, but every health care economist I know of figures that the biggest factor is that a single-payer monopsony can apply downward pressure on prices with its buying power and ability to enforce policy -- neither of which a fragmented market like ours can do. Obamacare stopped the rapid escalation of costs (you can see this in the graphs), but we do not enjoy the benefits of a thoroughly well worked out system like every other developed nation.

As to personal experience: I did transition to Obamacare, as did every member of my extended family. It has been a favorable deal for every one of us -- mildly for some, spectacularly for others.

So I agree completely that, even if you are now young and healthy, and feel aggrieved at sharing the risk, your perspective will change mighty abruptly the moment your cardiologist says you need a CABG.

That truth will become obvious to Republicans just as abruptly the moment they catch the car and repeal Obamacare.

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A for-profit system introduces opportunities for rent-seeking in every transaction, and there are many. This not only drives prices up astronomically, it introduces many players with incentives that run directly counter to those of the putative buyer, i.e. the health care "consumer." (Scare-quotes because insurance may be the only product where customers are happier if they get no use out of it.)

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I can believe that Sen. Thune would like one of more of his Republican colleagues to vote, McCain-like, against whatever insane healthcare “reform” the GOP comes up with. I’m not so sure about Speaker Johnson, whom I believe is a true believer, a soft-spoken, well-mannered fanatic.

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