Listening to the coverage of Trumpcare yesterday, something hit me: every single dang idea the Republicans are basing their backwards health care system reform on are truly, awfully terrible. A lot of the arguments they are making are completely awful, too. It’s such a cavalcade of hideously bad ideas that it seems almost weird.

Think about it. This is quite a run:

High risk pools. These are particularly egregiously terrible, because they go against the whole point of insurance, which is to taking the burden of the risk of getting hurt or sick that ALL of us face, then spreading that burden around to everyone. Taking anyone with a pre-existing condition and sticking them in a separate group (and then underfunding that!) is simply evil.

HSAs and high deductible plans. We have one of these. It’s awful. When our kid needed expensive dental work that wasn’t covered, we burned through the savings nearly instantly just in the diagnosis phase, then had to pay for the work out of pocket. It took us two years to pay it off. If either my wife or I had lost our jobs during that time, who knows what would have happened. And this wasn’t even a hugely expensive procedure. I realize the idea is that if people shop around that could bring down costs, but were we really going to try to find the cheapest, cut-rate dentist we could… for our kid?

Obamacare. I know, I know. I’m glad Obamacare exists. Don’t get me wrong. It’s helped a lot of people, including a friend of mine that was diagnosed with brain cancer and given a year to live. The support he was able to get from Obamacare let him live that year, rather than spending it doing battle with the health care system. I’m grateful to President Obama and the Democrats for passing it.

But. It’s also helpful every once in a while to take step back from the debate and think about the big picture: the fundamental reason insurance companies are so awful is that (for most of them, at least — Kaiser is to some degree an exception to this) the entirety of their financial incentives are a) for you to be sick and/or medicated, so they can sell you things and then b) to do anything they can to avoid paying you, or sticking with you with fees.

Keep in mind that Obamacare was based very largely on ideas the very conservative Heritage Foundation was peddling in 1993. It was an improvement on those ideas, no question. But at it’s heart, it was a conservative plan. One of the big things Obamacare fixed was around some of the terrible incentives insurance companies have to avoid paying you, by requiring what they called “Essential Health Benefits.” If you remove them, guess what you get? A subsidy machine for scams. (No wonder Trump likes this plan.)

So even though it was an improvement, because the Heritage/Obamacare plan did nothing to even start to address the problem of insurance companies sitting between us and our health care and absorbing money (like a public option, for example), I’m including it on this list.

Buying insurance across state lines. It’s bad enough dealing with an in-state insurance company. Why would I want to deal with some company that’s relocated to Delaware (or whatever state winds up with the most lenient laws) that doesn’t even have an office here? And how would this possibly be anything less than an unregulated race to the bottom?

Tort reform. Another idea that always gets thrown around is tort reform. This doesn’t seem to have even made it into Trumpcare, at least, which is good, because the savings from it don’t exist. It sounds good to blame lawyers for stuff though!

Cuts, cuts, cuts — particularly to the most vulnerable. From TPM:

…the bill would allow states to no longer be required to consider schools as Medicaid-eligible providers, a New York Times report found. That means the $4 billion in Medicaid reimbursements schools are said to receive — much of it going to caring for children with special education needs — would be vulnerable to cuts.

I’m actually a little speechless at that. If anyone sees Republicans defending that, I’d love to see what their arguments are.

Speaking of the arguments. Oh, the arguments.

Here’s a smattering of the worst of the lot:

“Sick people don’t deserve care.” Rep Mo Brooks, of Alabama, actually said exactly as much. This one probably doesn’t requiremuch of a rebuttal either. But thanks for going off-message and letting us know what you’re really thinking, Congressman! Maybe that’s why he feels ok cutting budgets for taking care of special needs kids?

“You don’t get healthcare with MY money.” I don’t know if Paul Ryan or Trump have said anything along these lines, but it’s definitely been a big hit with conservative activists on Twitter:

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Sorry Jimmy Kimmel: your sad story doesn't obligate me or anybody else to pay for somebody else's health care.

 — @WalshFreedom

This is one of those crappy arguments that seems sort of right, and clearly plugs into and amplifies their worldview, but is actually soulless and horrible if you follow it to its logical conclusion. Luckily, some old guy from Vermont came up with a pretty solid response:

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People who can't afford health care do not deserve to die. I don't know how we can make it any clearer than that.

 — @BernieSanders

“Don’t Let Washington Bureaucrats Make Decisions For Us.” This one has been a line of argument the leadership has used. It’s ridiculous, condescending and insulting to suggest we don’t understand those Darn Washington Bureaucrats are all that’s standing between us and the Giant Insurance Company Bureaucrats raiding us for everything we’ve got. The thread below this tweet is an elegant explanation of how this works, and an unfortunate example of how “fact-checking” in corporate media enables it:

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It just lets private insurance companies do that, which they will, because they have. This is sophistry. https://t.co/G4hXO5UD1l

 — @davidklion

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Unless the bill specifically says companies can't classify complications from rape as pre-existing conditions, then that's what will happen

 — @davidklion

Just flat out lying. Republicans are making up whole categories of lies to keep this thing afloat. Here’s a list of five whoppers. They’re not just individual lies, but really whole categories of falsehoods they are using to tell a story around this thing. And the big insurance companies have been getting in on the making shit up fun, too!

This one weird thing all these ideas happen to have in common

It’s weird that ALL of these ideas are so bad, right? You’d think they’d at least have a couple ideas that might work. Lying is hard, and even in American democracy, it catches up with you eventually! Even the Heritage/Obamacare plan may have had shaky fundamentals, but it made a lot of significant improvements in the details and how it was implemented. So why is this so bad?

What all these mysteriously awful ideas have in common is that they are uniformly great for these guys:

I’m sure it’s just a coincidence!

Obamacare was clearly pretty good for those guys too. So why is the GOP even doing this?

And yet, the insurance market hasn’t exactly been pummeled since Obamacare passed. In fact, their profits are up. Way up. Even the arch-conservative faux-populists over at the Weekly Standard reported this:

In 2008, the year that Barack Obama was elected as president, the combined annual profits of America’s ten largest health insurance companies were $8 billion. Under Obamacare, the ten largest health insurers’ annual profits have risen to $15 billion.

When Obamacare happened, it was puzzling that the right didn’t call it a vindication of their ideas and spin it at as the win that it was. But the unmitigated greed of the guys in that picture, and more importantly, the temptation to use it to fan the racist backlash against Obama, proved too tempting.

Bernie recently caused a hubub for suggesting that the GOP base wasn’t racist. Clearly, this is a ridiculous claim. Some Republicans are more racist and some are less so. As are many Democrats! But the problem isn’t that their base has a bunch of racists in it. The problem is that Republican leaders, particularly lately, have had no problem in fanning white racial resentment to advance their agenda. Democratic leaders don’t do this.(usually, anyway: Bill Clinton’s welfare reform was a shameful exception to this). Republicans have based a good amount of their argument on it ever since Nixon framed his backlash to the Great Society as benefits to the undeserving poor. Before Trump, they used code words and “dog-whistle” politics. Since Trump, they’ve quit bothering with the whistles and are just straight-up calling the dog.

The worst part is that, at least in the short run, this strategy totally worked.

But even if it worked this time, at some point they’re going to pay for this. Right?

In the short run (2018), it might cost them the house, and it might not. In the long run, it’s likely that it will.

I wish this was the part where I could say “the midterms are coming and we’re for sure going to kick their butts.” But no one really knows what’s going to happen. The GOP is very good at politics, and Dems have a huge midterm turnout problem. Even wrecking Obamacare might not be enough to turn that around.

I’ve been seeing quite a few ads online singing Trumpcare’s praises:

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Seeing lots of pro #Trumpcare marketing today, like this. Outrage from our side but not a lot of coherent arguments.

 — @DanAncona

But not much of a response, at least so far, from the left. If somebody accidentally put me in charge of ad strategy at the DCCC, I would have had an anti-Trumpcare online/TV campaign in the can ready to go for the moment it passed. But that doesn’t seem to have happened.

There are lots of lines of attack on Trumpcare. This could totally work:

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This is the brutal attack ad that awaits any Republican who votes for Trumpcare https://t.co/h38z265Fc2

 — @koronet

But the question is: will Dems have the intestinal fortitude to execute on any of these myriad lines of attack? The ad strategy I’ve seen most candidates taking so far in the special elections has been a “play it safe, don’t get into anything substantive” kind of approach. (I won’t name names, but my favorite online video example of this year had a theme of “standing up for what we believe in,” but also managed to avoid mentioning anything the candidate actually believed in. Takes some real skill to pull that off.)

In the long run, conservative ideas fail. And when either the electorate either gets too diverse or wises up to the resentment game they are playing, or both, their political strategy fails too. The analogy is California, post Prop 187. It passed, was found to be unimplementable and unconstitutional, and the GOP has been essentially decimated since then. (Schwarzenegger’s eight years as Governor were the exception.)

Conservatives are basically junkies: they’re hooked on the cheap electoral highs of corporate dough, vote suppression and playing white resentment like a fiddle, rather than delivering ideas that work for ordinary people. At some point, climate change, inequality and the growing realization that they’ve been duping people will catch up with them. But Dems won’t get those voters unless they start making arguments that their ideas are better and they deserve to run the country.

The good news is: there is something you can do!

Not about the midterms, oh no. Unless you’re deciding message for a congressional candidate, there’s not a whole lot you can do about this. We’re good and doomed! (I’m kidding! Keep reading.)

However, you can read my book, and at least you’ll have a few hours of feeling what it feels like to really win, while seeing crappy conservative market-fundamentalist ideas getting stomped into oblivion:

Venus Shrugged: Part 1

I personally guarantee it will make you feel better about things (at least briefly), or I will give you a full refund of your $4.

If you’re hard up for the four bucks or your reading list is already overflowing, I get it. You can join my new very low-volume but illuminating email list, Imagination Battle. As soon as Part 2 of the book is ready to go, you’ll both be the first to know.

And I’m kidding about the election, of course, too. There are lots of groups doing amazing things. You should join them. Including joining your local Democratic Party, as shocking as that sounds. This will be the topic of my next post!