A Futile and Stupid Gesture: The History of the First Trump Presidency & Q-Anon

[Arnathor]

Students in North American colleges would rather learn about Identity politics + intersectionality, STEM sciences and doctors be damned.

 

[doghouse]

I am.

Why can't insurance companies be the ones to provide common services across states?

You don't need federal anything... if a state wants to divest itself from providing anything, it can. Verizon does it with cell phone plans.

I'm still not understanding how you believe the competition across state lines and giving states control of healthcare are mutually exclusive, as you suggested.

If the companies don't provide standard basis care across the whole country, they de facto aren't competing. They are localizing to drive up margin. The nonsense health plan they just threw out was going to crush rural elderly (like premiums from a couple grand to 30 grand) because their cost of care is so much higher in rural areas. These people aren't able to buy a plan from say, Virginia or Ohio, they are a captive market, and no insurer is going to give that up. If you aren't pulling in the cheap care from NYC or the like, then you can't lower cost in Arkansas. It will drive down costs to be able to leverage the profitable areas against the expensive ones, which, not coincidentally is Obamacare's biggest failing. While we are on the subject we can correct your earlier error that Obamacare is going to implode. It isn't, and no one with any sense thinks that it will. It will lumber along inefficiently while squeezing out marginal coverage areas because of the very reasons we are discussing.

This isn't rocket science.

 

[doghouse]

Paywall

When it comes to political malpractice, failing on repeal-and-replace is not Exhibit A. For weeks there has been a more obvious question for Stephen K. Bannon and President Trump: Why are they driving Senate Minority Leader Charles E. Schumer into the arms of the implacable opposition?

Wouldn’t the smart play be to coerce, or induce, or at least leave a tiny bit of room for Schumer (D-N.Y.) to cooperate? Wouldn’t the natural first move for Trump have been to assemble, from both parties, a populist majority in Congress?

Last week two of my Post colleagues, conservative commentators Marc Thiessen and Ed Rogers, argued that Schumer is sinking his party’s 2018 prospects by joining the irreconcilable resistance instead of working with the president where possible. By leading a filibuster against Supreme Court nominee Judge Neil Gorsuch, voting even against Transportation Secretary Elaine Chao (wife of Senate Majority Leader Mitch McConnell [R-Ky.]) and generally refusing to play ball, Schumer is showing that he didn’t get the 2016 message from middle America, they opined.

The Daily 202 newsletter

A must-read morning briefing for decision-makers.



Thiessen and Rogers may be right that uncompromising resistance will not help Democrats win independent voters in 2018.

[After the health-care fiasco, Trump’s next move may be even more disastrous]

Schumer says his 'vote will be no' on Gorsuch
Play Video0:59
Senate Minority Leader Charles E. Schumer (D-N.Y.) said Judge Neil Gorsuch, President Trump’s pick to serve on the U.S. Supreme Court, should have to get 60 votes to secure his confirmation and if he fails in that regard it'll be time to "change the nominee." (Reuters)
But their analysis overlooks two points: Trump’s behavior from Inauguration Day on left Schumer no choice. More important, what’s bad for Democrats isn’t necessarily optimal for Trump — especially if his and Bannon’s goal was to blow up both parties and forge a new working-class, nationalist majority that can carry Trump to triumphant reelection in 2020.

To be clear: I think that’s the wrong goal for our country. But if Trump had begun his administration by seeking a bipartisan infrastructure bill, Schumer would have had no choice but to cooperate, and might well have welcomed the chance. Half the unions that normally support Democrats would have been on Trump’s side and pressing both parties to get on board.

Instead, Trump opened his presidency with a dark and one-sided address that gave no credit to his predecessor and opened no doors to cooperation. He followed that address with bizarre misstatements about crowd size and tweets mocking the protesters who marched in vast numbers the next day. “Why didn’t these people vote?” Trump taunted.

“These people” were Schumer’s base. Only days into the administration, thousands of liberals were demonstrating outside the Brooklyn apartment building where the senator lives. “Grow a spine, Chuck!” they demanded. “Filibuster everything!”

Even then, you might have made a case that for the good of his party, and the country, Schumer should stand up to his left wing. But he would have had to make common cause with a president who was belittling him as “head clown” and “Fake Tears Chuck Schumer.”

Even more difficult, he would have had to make cause with a president who selected as his first objective the erasure of President Barack Obama’s principal accomplishment. No Democratic leader could be in any way accomplice to that goal and expect to survive. No Democratic leader would want to.

Imagine if Trump instead had told House Speaker Paul D. Ryan (R-Wis.) that repeal-and-replace, and even tax cuts, had to wait. Imagine if Bannon had insisted that Congress first take up his trillion-dollar infrastructure plan.

There would have been some grousing from deficit hawks. But we’ve seen often enough that the one place Democrats and Republicans can find common ground is on measures that worsen the deficit.

[The lessons Trump and Ryan failed to learn from history]

There would have been disagreements, too, on the structure of the plan — how to pay for at least some of it, how to balance spending on roads with spending on mass transit, how radically to gut environmental protections on behalf of speed of execution.

But the pressure on Democrats to cut a deal would have been enormous. Would it have split the party? All the better, from Trump’s point of view. And if it split the Republicans, too, wouldn’t that have advanced the grand Bannon plan for world domination?

Which leads to an interesting question: Why didn’t Trump start with infrastructure and cooperation?

One possibility is that he didn’t because he couldn’t, temperamentally. He couldn’t control his jeers and insults, and Bannon couldn’t control them either, so before the administration could even choose its first priority, the decision was essentially made for it: Democrats had been alienated and Trump had to start with initiatives that he thought could pass with only Republican support. The simultaneously gathering cloud regarding Russia only made it more certain that no Democrats could be seen advancing a Trump initiative.

Another possibility is that the more conventional Republicans inside the administration — Chief of Staff Reince Priebus, Vice President Pence — argued for more conventional Republican goals and won.

Whatever the case, Trump missed an opportunity to reshape politics that may not present itself again.

Read more from Fred Hiatt’s archive, follow him on Twitter or subscribe to his updates on Facebook.

Read more on this topic:

Marc A. Thiessen: Why Schumer’s unrelenting resistance thrills conservatives

Kathleen Parker: Trump finally gets a good sense of what governing is like

David Ignatius: Trump is not so Machiavellian after all

Ed Rogers: The Democrats’ ditch is only getting deeper

 

[doghouse]

Olo, you are an expert in hyperboles.

Top Top Hyper Expert ©

 

[Monkeyface]

doghouse as always, you're the voice of reason this thread needs so desperately

 

[doghouse]

Fuck, I hate being the voice of reason.

Here's some lulz.



What kinda prole uses a fucking Keurig.

 

[OfficePants]

If the companies don't provide standard basis care across the whole country, they de facto aren't competing. They are localizing to drive up margin. The nonsense health plan they just threw out was going to crush rural elderly (like premiums from a couple grand to 30 grand) because their cost of care is so much higher in rural areas. These people aren't able to buy a plan from say, Virginia or Ohio, they are a captive market, and no insurer is going to give that up. If you aren't pulling in the cheap care from NYC or the like, then you can't lower cost in Arkansas. It will drive down costs to be able to leverage the profitable areas against the expensive ones, which, not coincidentally is Obamacare's biggest failing. While we are on the subject we can correct your earlier error that Obamacare is going to implode. It isn't, and no one with any sense thinks that it will. It will lumber along inefficiently while squeezing out marginal coverage areas because of the very reasons we are discussing.

This isn't rocket science.

Giving insurance companies the ability to insure across state lines gives them reach. States can take advantage of the cost savings. The more insurance companies in your state, the more competition, the lower prices go. Seems like pretty basic economics and logical to me, like, not rocket science.

Again, I fail to see anything here that is mutually exclusive.

Implosion, in my view, has already happened. It's a subjective term. 1/3 of counties already have only 1 provider. That isn't going to improve. Implosion is not only about cost, its about choice, and what was promised thru the legislation has not come even close to meeting the Obama sales job. To me, that's failure.

 

[doghouse]

Giving insurance companies the ability to insure across state lines gives them reach. States can take advantage of the cost savings. The more insurance companies in your state, the more competition, the lower prices go. Seems like pretty basic economics and logical to me, like, not rocket science.

"Reach" is not a quality that makes any difference. Cost amortization of the sick population is what matters. And States don't take advantage of anything, they are pass through entities.

Insurance companies are not going willfully give up profit centers.

It is simple economics, however your logic is faulty.

 

[Grand Potentate]

We regulate our power and other utilities here, but not our health care?

and our utilities are, by and large, a fucking disaster. mainly given to our completely captured political class, but still.

 

[doghouse]

and our utilities are, by and large, a fucking disaster. mainly given to our completely captured political class, but still.

A disaster? Interesting. I am curious how you tapped out this message that has been beamed around the world. Do you have some special smoke signal to digital converter?

 

[Grand Potentate]

Giving insurance companies the ability to insure across state lines gives them reach. States can take advantage of the cost savings. The more insurance companies in your state, the more competition, the lower prices go. Seems like pretty basic economics and logical to me, like, not rocket science.

this is good in theory but not practice. insurance companies have already express unwillingness to compete themselves across state lines when the proposition was put to them. also, interstate competition will do almost nothing to manage costs. health insurance is not like auto insurance.

 

[doghouse]

Y'all are hilarious. Seriously.

 

[Grand Potentate]

A disaster? Interesting. I am curious how you tapped out this message that has been beamed around the world. Do you have some special smoke signal to digital converter?

we can parse this into a different thread if you want but i don't consider artificially pumping shareholder prices in an effort to provide overpriced services and a completely captured market that will do everything they can to continue to pollute and screw over the people in their areas "efficient."

 

[Grand Potentate]

Y'all are hilarious. Seriously.

here we go with this "there used to be bubonic plague and polio and now its gone so stop complaining" shit.

 

[doghouse]

we can parse this into a different thread if you want but i don't consider artificially pumping shareholder prices in an effort to provide overpriced services and a completely captured market that will do everything they can to continue to pollute and screw over the people in their areas "efficient."

Okay, time for a visual representation of the spectrum that contains disaster and efficient.

|--Disaster----------------------------------------------------Normal------------------------------------Efficient-----Optimal--|

here we go with this "there used to be bubonic plague and polio and now its gone so stop complaining" shit.

It's more "stop being hilariously dramatic because you sound like a teenage girl."

Plus I wouldn't write off polio just yet.

 

[Grand Potentate]

Plus I wouldn't write off polio just yet.

pakistan 2020!

 

[OfficePants]

"Reach" is not a quality that makes any difference. Cost amortization of the sick population is what matters. And States don't take advantage of anything, they are pass through entities.

Insurance companies are not going willfully give up profit centers.

It is simple economics, however your logic is faulty.

States are not pass thru entities, since they regulate and legislate the industry.

Reach absolutely matters, you're ignoring the economics of scale. Obamacare has protected against pre-existing medical conditions but started punishing people with pre-existing zip codes.

A way to combat this is to group insure your state, mixing cities with rural areas. And states can strike deals with other states to further increase their reach thru partnership.

 

[doghouse]

States are not pass thru entities, since they regulate and legislate the industry.

Reach absolutely matters, you're ignoring the economics of scale. Obamacare has protected against pre-existing medical conditions but started punishing people with pre-existing zip codes.

A way to combat this is to group insure your state, mixing cities with rural areas. And states can strike deals with other states to further increase their reach thru partnership.

There is no economy of scale to gain, these are already national companies.

Yes, you have to mix rural and urban, rich and poor, which means rich and poor states. Mixing rural and urban Kansas doesn't really mean anything. Obamacare actually disproportionately helped the rural anyway.

 

[InstaHate]

Machine learning is improving rapidly; there are already some diseases which are more accurately diagnosed by AI than the average GP. That'll (eventually) drive doctor salaries down, though I'm guessing that those salaries only account for a fraction of US healthcare's bloated costs.

 

[doghouse]

Machine learning is improving rapidly; there are already some diseases which are more accurately diagnosed by AI than the average GP. That'll drive doctor salaries down, though I'm guessing that those salaries only account for a fraction of US healthcare's bloated costs.

I, for one, welcome our new robot overlords.

 

[OfficePants]

There is no economy of scale to gain, these are already national companies.

Yes, you have to mix rural and urban, rich and poor, which means rich and poor states. Mixing rural and urban Kansas doesn't really mean anything. Obamacare actually disproportionately helped the rural anyway.

You're talking about national companies with glass walls between their ability to operate and offer cheaper plans, for example from a state that has less regulation.

The mix you are talking about already exists at a national level.... and isn't working.

 

[Thruth]

It's not huge, certainly not half. And more detailed data shows GPs make less but specialists more. Besides, where would US doctors go to get paid more? They'd need to get new licenses as well, so pretty inelastic I'd say.

So, doctors take a 30% pay cut, but getting sick does not mean bankruptcy anymore for the average person. Nice trade off. Colleges would be forced to lower tuition fees as well. Everyone wins in the long run (except pharma sharedholders and overpaid college administrators).

No doc is going to take a 30% pay cut. Nor would all the nurses that enjoy better pay than in most other countries.

Tuition fees are not going down either. They are not linked to doc salaries. Cost of educating a doc would remain the same regardless of salary.

 

[formby]

Ya'll gotta socialiyz da costz....

 

[Monkeyface]

No doc is going to take a 30% pay cut. Nor would all the nurses that enjoy better pay than in most other countries.

Tuition fees are not going down either. They are not linked to doc salaries. Cost of educating a doc would remain the same regardless of salary.

So where all the docs going to get better pay? Tuition is directly linked to salary. One of the main arguments against job/immigrant visas in the US is that foreigners graduate with little to no student debt, which is unfair competition compared to Americans graduating with 100k-250k debt.

I, as a foreigner, would be willing to accept a lower salary than an American because I have no debts to pay off, even though my education was just as good.

The main argument for doctors getting high salaries in the US is because they have massive debts to pay off (and high malpractice insurance). Tuition has increased significantly more than inflation in the US, yet quality hasnt increased all that much. It's called cost disease, look it up.

 

[OfficePants]

Doctors will get better pay by being private doctors outside a nationalized system. Like in England, where they import doctors from Ghana and India to cover for the fact that practicing medicine is like working on an assembly line.

Debt is the student's problem. Want less debt? Go to a community college and forgo the "experience". It's all ultra-leftist brainwashing anyway.

You would accept a lower salary so you can live here. And that is what all these foreigners on the H program are doing. They take lower pay, and take away jobs from US citizens. And if they try this shit with doctors, they'll import them. Win for globalists.

The fundamental problem with healthcare is that the consumers have no idea what anything really costs.

 

[Grand Potentate]

Go to a community college and forgo the "experience"

are there any community college medical programs currently certifying doctors in the united states?

 

[Grand Potentate]

You would accept a lower salary so you can live here. And that is what all these foreigners on the H program are doing. They take lower pay, and take away jobs from US citizens. And if they try this shit with doctors, they'll import them. Win for globalists.

http://cepr.net/blogs/beat-the-press/economists-doctors-cartels-and-uber

Economists, Doctors' Cartels, and Uber

Breaking the taxi industry cartel's and promoting Uber has been somewhat of a cause célèbre among economists in recent years. Any card carrying economist can give you the two minute tirade on the evils of the taxi cartel and the benefits of Uber. (I can too, but the argument should be for modernized regulation, not Uber gets to do whatever it wants because it's Uber, see pieces here, here, and here.)

What is striking is that the enthusiasm for the virtues of competition seems to disappear when we switch the topic from the taxi cartel to the doctors' cartel. Doctors actually have been far more effective than taxi companies in limiting competition. Doctors largely get to set standards of care, which not surprisingly requires twice as high a percentage of highly paid specialists as in other wealthy countries. They also restrict the number of doctors with a wonderfully protectionist rule that prohibits doctors from practicing in the United States unless they have completed a U.S. residency program. This means that even well-established doctors in places like Germany, France, and Canada would face arrest if they attempted to practice medicine in the United States.

As a result of this cartel, doctors in the U.S. earn on average more than $250,000 a year, putting the average doctor not far below the one percent threshold, even assuming no other family income. This is roughly twice the pay as the average doctor earns in other wealthy countries.

It is striking that the doctors' cartel gets so much less attention from economists than the taxi cartel. After all, we spend close to $250 billion a year on doctors compared to $6 billion a year on taxis. I could suggest that the lack of interest is due to the fact that many economists have parents, siblings and/or children who are doctors, but I wouldn't be that rude.

Anyhow, there are measures that can be taken at both the national and state level to break the cartel if economists ever take an interest in free trade. At the national level the obvious step would be to establish an international certification system so that doctors trained in other countries could establish their competency and then practice in the United States just like a doctor born and trained here. (Save the whine. We can establish a system whereby we repatriate money to developing countries for the doctors they train who then practice in the United States. As it stands, they get zero money for the doctors that leave the country, so this system would almost certainly be a net improvement for them. Yes, this is discussed in Rigged.)

Since protectionists dominate trade policy (I mean up until now, not just since the election of Donald Trump), we can also look to measures at the state level. It seems that several states are considering policies that would allow doctors who do not complete a residency program to practice under the supervision of another doctor. This is a great first step as is expanding the scope of practice for nurse practitioners and other less highly paid health care professionals.

Developments in technology should allow health care professionals with much less training than doctors to make diagnoses as accurately or more accurately than the best doctors. The same is true with robotics, which is likely to eventually outperform even the best surgeons. These technologies will offer both huge savings and better care, if we don't allow the doctors' cartel to maintain its lock on the practice of medicine.

 

[OfficePants]

are there any community college medical programs currently certifying doctors in the united states?

You and I both know the answer is no. I thought everyone understood I was talking about undergrad.

 

[OfficePants]

international certification system so that doctors trained in other countries could establish their competency and then practice in the United States

Is this what you want determining if you are on the verge of a heart attack? Pass on that shit.

Cheating is absolutely rampant. International certification MY ASS. This is globalist cesspool talk. Come back and talk to me in 100 years when these cultures clean up their acts.

 

[Grand Potentate]

You and I both know the answer is no. I thought everyone understood I was talking about undergrad.

that is not where the majority of their student debt comes from so i'm not sure how that's even relevant?

Is this what you want determining if you are on the verge of a heart attack? Pass on that shit.

Cheating is absolutely rampant. International certification MY ASS. This is globalist cesspool talk. Come back and talk to me in 100 years when these cultures clean up their acts.

i hate to break it to you but the doctors we have here aren't exactly a pony ride either. as someone who has and continues to spend a significant amount of time dealing with these jokers I can tell you that the american ones don't know what the fuck they're doing either. its all guess work in a white coat. at least with the foreign ones you wouldn't have to go bankrupt.

 

[Monkeyface]

Doctors will get better pay by being private doctors outside a nationalized system. Like in England, where they import doctors from Ghana and India to cover for the fact that practicing medicine is like working on an assembly line.

Debt is the student's problem. Want less debt? Go to a community college and forgo the "experience". It's all ultra-leftist brainwashing anyway.

You would accept a lower salary so you can live here. And that is what all these foreigners on the H program are doing. They take lower pay, and take away jobs from US citizens. And if they try this shit with doctors, they'll import them. Win for globalists.

The fundamental problem with healthcare is that the consumers have no idea what anything really costs.

Actually, I'm getting paid the same as an American. I'm just saying, my monthly expenses are much lower because I don't have debt, so I would be able to survive on a lower salary. Now I can spend it on a nice American made car and stimulate the economy!

 

[OfficePants]

that is not where the majority of their student debt comes from so i'm not sure how that's even relevant?

Ok, 4 years of college @ 60k.

Or community college 2 years @ 5k + 120k.

Total undergrad 240k versus 130k.

Almost 1/2 the cost.

Add post grad: 200K?

440k vs 330k.

Please tell me how this is not a substantial?

i hate to break it to you but the doctors we have here aren't exactly a pony ride either. as someone who has and continues to spend a significant amount of time dealing with these jokers I can tell you that the american ones don't know what the fuck they're doing either. its all guess work in a white coat. at least with the foreign ones you wouldn't have to go bankrupt.

I will take a US trained doctor vs an Indian doctor any day. Yes, sometimes it's a guessing game, but I would rather trust the devil you know. I'd rather go bankrupt.

 

[doghouse]

I will take a US trained doctor vs an Indian doctor any day. Yes, sometimes it's a guessing game, but I would rather trust the devil you know. I'd rather go bankrupt.

We've already established your critical thinking skills need work.

Besides most of the Indian ones are schooled here anyway. And half our doctors are already Indian.

 

[OfficePants]

We've already established your critical thinking skills need work.

Besides most of the Indian ones are schooled here anyway. And half our doctors are already Indian.

You're drinking the curry flavored Kool-Aid. My critical thinking skills are A-OK. Your facts are what needs work, dear friend.

http://kff.org/other/state-indicator/distribution-by-race-ethnicity/?currentTimeframe=0&sortModel={"colId":"Location","sort":"asc"}

Distribution of Medical School Graduates by Race/Ethnicity 2015

White 10992
Black 1061
Asian 3701
Hispanic 854
Non-U.S. Citizen/Non-Permanent Resident 355

Not even close to being near to being close to being half.

 

[doghouse]

No, the actual figure is 5%, I was just trying to join in the hyperbole y'all are so fond of.

But regardless, Indian docs are fine. But I'm sure you can find plenty of whiteys if it suits you.

 

[Grand Potentate]

But regardless, Indian docs are fine. But I'm sure you can find plenty of whiteys if it suits you.

indians, just like the other races, shake out the same way - there's a few winners and a whole lot of losers.

 

[doghouse]

indians, just like the other races, shake out the same way - there's a few winners and a whole lot of losers.

Yup

 

[doghouse]

 

[OfficePants]

No, the actual figure is 5%, I was just trying to join in the hyperbole y'all are so fond of.

But regardless, Indian docs are fine. But I'm sure you can find plenty of whiteys if it suits you.

Judging by your use of twitter to wax hard on the vapid, seems the hyperbole emanates from your posts more than being a response. Or I called you out

Any doctor trained outside the US save for a few countries is a risk to me, and I wouldn't want to use one. This is not a phobic statement, it's just an observation on the lack of trust I have in the rest of the world. For me, it's not populism, it's a well reasoned observation that it's too easy to become a doctor most everywhere. In some countries you can start being a supervises physician after 2 years of college. Pass on that mess.

 

[Grand Potentate]

In some countries you can start being a supervises physician after 2 years of college.

which ones?