The Trumpcare Scam

I wanted to take a break from writing hair-on-fire warnings of the coming stolen election. But first I have to link to Dana Milbank’s column today, because now Milbank’s hair is on fire too. This is not a drill. The Reichstag is burning.

For five years, my colleagues and I have taken pains to avoid Nazi comparisons. It is usually hyperbolic, and counterproductive, to label the right “fascists” in the way those on the right reflexively label the left “socialists.” But this is no longer a matter of name-calling.

With his repeated refusals this week to accept the peaceful transfer of power — the bedrock principle that has sustained American democracy for 228 years — President Trump has put the United States, in some ways, where Germany was in 1933. That is when Adolf Hitler, the appointed leader, used the suspicious burning of the German parliament to turn a democracy into a totalitarian state.

And so on. And Milbank is not normally a hair-on-fire kind of guy. See also David Siders and Holly Otterbein, Pollitico, ‘Everyone sees the train wreck coming’: Trump reveals his November endgame.

But now I want to back off from the apocalypse and focus on something less threatening, which is the possible meltdown of our health care system. The Affordable Care Act comes before the Supreme Court in November, after the election. With a new right-wing nutjob justice on the bench, it’s entirely possible the Court will nullify the entire law. John Roberts might rather they didn’t, but he’s not going to be able to be a swing vote any more. Anything is possible.

Trump thinks he has his ass covered by signing an executive order that allegedly protects insurance coverage for pre-existing conditions. He’s been talking about signing such an order for weeks, and yesterday he finally did it.

President Trump on Thursday signed a largely symbolic executive order aimed at protecting people with pre-existing conditions as he takes fire for a lawsuit seeking to overturn ObamaCare, which enacted those protections.

“The historic action I am taking today includes the first-ever executive order to affirm it is the official policy of the United States government to protect patients with pre-existing conditions,” Trump said during a speech in North Carolina, a key swing state. “So we’re making that official.”

Trump noted “our opponents, the Democrats, like to constantly talk about” health care and pre-existing conditions, but “now we have it affirmed, this is affirmed, signed and done.”

The White House did not immediately release the text of the order, but from Trump and other officials’ descriptions it simply states that protecting people with pre-existing conditions is the policy of the government, something that does not have the force of law on its own.

Whether Trump understands that the Affordable Care Act already protected people with pre-exising conditions, or even that he understands why “pre-existing conditions” is an issue, is not clear. And, of course, “the policy of the government” doesn’t mean beans to the private insurance companies, who are the ones who will refuse to cover people with pre-existing conditions if the ACA is dead.

The executive order must have been released. See Paul Waldman, today.

Trump has a “better” plan. Just like the better future you’ll have once you give your life savings to Trump University to learn his real estate secrets.

In the software industry they call this “vaporware” — a product announced with great fanfare that never actually exists.

I would point out that the ACA is over 900 pages long, as befits a law that sought to re-engineer an impossibly complex system. As Trump himself marveled when he first tried to repeal it, “Nobody knew health care could be so complicated.” Everybody knew that, except for him.

Trump’s executive order, on the other hand, is not complicated at all, nor is it a “plan.” After a few pages extolling the fantastic work his administration has done on health care, it says it will do things like lower costs and expand access. How? Don’t ask.

That’s it. That’s Trump’s health care plan, apparently. As Waldman says, it’s like releasing a plan to become a billionaire, consisting of “Step One: Become a billionaire.”

Here’s another bit of weirdness. A few days ago, the New York Times reported that Trump and the pharmaceutical industry were very close to a deal that would have lowered prescription drug prices. This would have been a major coup, had it not fallen apart at the last minute.

The breaking point, according to four people familiar with the discussions: Mark Meadows, Mr. Trump’s chief of staff, insisted the drug makers pay for $100 cash cards that would be mailed to seniors before November — “Trump Cards,” some in the industry called them.

Some of the drugmakers bridled at being party to what they feared would be seen as an 11th-hour political boost for Mr. Trump, the people familiar with the matter said.

But the “Trump cards” were nonnegotiable, as far as the White House was concerned. So the pharmaceutical industry backed out of the negotiations.

“We could not agree to the administration’s plan to issue one-time savings cards right before a presidential election,” said Priscilla VanderVeer, the vice president of public affairs at PhRMA, the industry’s largest trade group. “One-time savings cards will neither provide lasting help, nor advance the fundamental reforms necessary to help seniors better afford their medicines.”

Then this happened yesterday, Waldman says:

Trump said in his speech that in the next few weeks the government will be sending $200 prescription drug discount cards to 33 million Medicare beneficiaries. “Nobody has seen this before,” he said. “These cards are incredible.”

Given that doing so would cost $6.6 billion and the president can’t simply do that without an act of Congress, if it actually happened it would almost certainly be illegal (the White House claims they can do it through a program they’ve proposed but that does not yet exist, I kid you not). Furthermore, a one-time $200 payment does nothing to solve the enormous problem of high drug costs.

There’s no Trump health care plan, there’s no program to issue discount cards, it’s all just a scam. Trump is promising the moon to get himself re-elected.

Unfortunately, “health care” is not one of the announced topics to be covered in the upcoming presidential debate. A damn shame.

18 thoughts on “The Trumpcare Scam

  1. Unfortunately, “health care” is not one of the announced topics to be covered in the upcoming presidential debate. A damn shame.

    Biden should find a way to bring it up anyway.  Health care is a topic too important to many if not most Americans.  And he's be doing us all a service to draw Trump out on his "plan" and not only expose its fraudulence but also all the lies Trump has told about the ACA.  Most of all, tell the public how Trump is dead set on destroying the ACA, and challenge him before the public on his lawsuit.  

    Trump took credit for all the good Obama had done — healthcare, the economy, for starters, and through ideological idiocy and/or sheer incompetence, ran it in the ground.  I want to see Biden use the debates to expose him on all of it.  Voters living in the real world, e.g. most of us, want to see that too.

  2. In the days when I advised, I would tell students that at best you will get taught 80% of what you need to be a competent (fill in the blank).  The rest is on you.  The American health care system might be only 75% in comparison and way more expensive.  They might give you about 75% of what you need to be healthy and that figure goes to 25% or less when it comes to mental health.  That is a do it yourself game for sure.  

    So Trump wants to do a last ditch attempt to buy senior votes.  No one will change the abortion that is Medicare part D.  What a giant subsidy to the drug industry.  All for nothing.  All we have done is created cesspools of drug industry greed and incompetence.  So he is loosing senior votes.  Well hell yes. 

    So he thinks he can just give them a drug voucher.  That them is me.  I respond with a stream of expletives %%&^&##@%*(&)^&^%&^$&%%^^%%*&^*&(&@@Q!!II+_)(_&**(^*&(^%%^$&&^&^&(*___((&(*&&^#.  Having spent two of the last three months in various hospitals, we have some marginal health care left in this country.  You have better be able to kick in a good 25% of the effort to get well yourself, and bless you if you do not have the best insurance possible and funds to spend.  Other than that, I have nothing to offer that if I had to pay cash for one leg brace I got that would have cost list price about $600.00.  I bet the antibiotics I got would have a list price that would inflict terror.  

    For a $200.00 drug voucher, you get a cheap therapy session on the reality of medical care in the USA.   You won't get my vote and I think you owe America a national mental health debt beyond your ability to pay even at two bits on a dollar and America does the remaining 75%.  Oh Trick or Treatment.  With Trump you get snake oil in a gold flake bottle and a voucher to defray the inflated cost.  He might dupe some gullible seniors with that, but seniors vote and seniors have turned hard against Trump.  

  3. "The Flim–Flam Man" (A brief one act play).

    * Scene opens*

    "Hey, Mutt!"

    "Hey, Jeff! "

    Mutt (M):  So listen go THIS  I just came from some new traveling salesman down the road comin' home from work, and I asked if he had any Flim, – you how I love drinkin' that stuff – 'n he said yeah, and I got a great deal on it!  I got got a quart for only $25!!

    Jeff (J):  Ha!  You got rooked!  I got one for only $20 just an hour ago!  He musta seen YOU comin'!  

    M:  Damn!  He ripped me off!  Crook.  I bet I got rooked on my deal for Flam too man!  Ya know you can't drink Flim without Flam!  I got it for $20.  You?"

    J:  Damn!  He ripped ME off!   Goniff!  I paid $25!

    M:  I got 'Flimmed!'

    J:  'N I got 'Flammed!' 

    M & J together:  We've been Flim-Flammed!!!


  4. The devil is in the details. I'm looking at the nuts-and-bolts of an election power grab.  Trump will try – I believe that. We need to do everything to thwart it – vote in person if you can. But there's a lot Trump can't do because even a presidential election is counted at the state level. If you are a state official asked to commit election fraud because it's the only way Trump can win, you might want to check with your lawyer your legal exposure for that fraud if Trump doesn't win. 

    I don't know the answer – I am no lawyer but if I'm a Republican in GA and I demand the count stop and exclude mail-in votes, are federal laws broken? The other scam I find disconcerting requires the state legislators set aside the popular vote and designate a slate of electoral college electors who will ignore the popular vote. Again, if you are a state legislator asked to cast a public vote to set aside the decision of the majority,  that may be political Hari-kari. For sure, some will. In some states, most will, but in the most critical states, will all Republicans vote to set aside the popular vote? 

    The Pentagon announced they will not get involved in the transition of power. That cuts two ways – they won't evict Trump, but it also suggests they won't put down mass protests if Trump tries to steal the election. And the protests will make BLM look like Little League if Trump tries to cling to power when he lost. (I'd like Biden to say there will be federal prosecutions for anyone who participates in suppressing the vote, or otherwise meddling in the fair and full count of all votes.) MASS demonstrations need to happen in the states where the idea is suggested that the popular vote be set aside. I mean mob the state capitol to the degree that legislators are fully aware how dangerous the mob is.

    I'm glad this isn't Nixon. He was crooked but competent. There's very little skill in the West Wing. Trump will try, but nobody wants to take the fall for trying to fix the election if Trump fails. (I'm also unclear about getting the election in front of the USSC – didn't Gore agree to let the court make the decision? That was a situation where A Bush was governor of Florida and the political calculation that Gore might prevail there in a process the Constitution never authorized.)

    IMO, the first plan is to steal the election by using the legislators in the states to set aside the popular vote and put up a phony electoral college slate. But that might not work. Trump can't set it up in advance in the open and it's not clear which states Trump would need to try it.  If that scheme fails, then Trump will try to drag the election in front of the USSC if Trump has lost the Electoral College, but would the court agree to hear the case if the Constitution is clear and the EC vote is confirmed? 


    • if you are a state legislator asked to cast a public vote to set aside the decision of the majority, that may be political Hari-kari.

      Republicans in power have demonstrated over and over that they think they’re right. That’s all that matters. That the public may toss them out doesn’t really impinge on their self-confidence.

      I’m glad this isn’t Nixon. He was crooked but competent. There’s very little skill in the West Wing. Trump will try, but nobody wants to take the fall for trying to fix the election if Trump fails.

      Less skill but way more numbers and broad corruption in the institutions that matter (DOJ and Courts). These people have lived their whole lives, believing in “might makes right”, successfully navigating among people who are way more skilled, but nonetheless outsmarted and outgunned by themselves. They’re far more cunning than skillful, and they’ve made it work.

    • IMO, GOP Plan A is just what they've been working on for the last couple decades: rigging elections in states they control, by (1) blocking & purging Registration by likely Dems, (2) making it harder for likely Dems to vote on election day (shorter hours, fewer locations, particularly in cities), (3) manipulating results of touch-screen voting, and (4) other cheating that we haven't heard of yet.  But yeah, I agree that the tricks Doug describes are the GOP's Plan B.  Even worse, Plan C seems to be Civil War.

  5. I'm pleasantly surprised that Big Pharma resisted Trump's blatant plan to have them fund his campaign bribery.  But that choice is likely related to the Centrist Democrats' smackdown of Medicare for All.

  6. Frank Rich:

    The possible doomsday scenarios for Election Day — or election week, or month, or months — are so many that we can no longer keep count….Trump knows he’s losing as of now and will gladly provoke a constitutional crisis to delegitimize or steal the election, sow chaos, and delay or challenge any count not going his way. And he has teams of Republican lawyers and state lawmakers, not to mention the Attorney General, to do his bidding. He has also vowed to send law-enforcement officers to polling places in battleground states, no doubt to intimidate the voters he wants to suppress.

    … will not be Trump who decides whether there will be a peaceful transition or not; it will be his troops. By troops I don’t mean the American military, which is unlikely to bear arms to support any Trump effort to cling to the White House in defeat, but Trump’s own troops, who have formed a rogue military of their own. His language has already given them the signal to do whatever the hell they want…

  7. I am confused as to who would be responsible for escorting Trump out of the White House in case it has definitely been decided Biden has won and he refuses to leave.  Secret Service has to protect him as an ex-president and it doesn't seem like the military would get involved.  Can someone help me out? 

    • I can't answer that question, and I have asked that myself.  But it is good to hear from you and I worry that the dust bugs under your bed have gotten to you somehow.  I am always a fan of your comments.  Stay well.  

      • Bernie:  Thank you for your concern.  It is nice to be missed.  Actually, I had to exit my position under the bed because the dust bunnies were becoming annoying.  However, lately I am entertaining the thought of returning.  Perhaps the dust bunnies have missed me and will throw a party.  Ice cream and cake sounds good right now.

    • I am confused as to who would be responsible for escorting Trump out of the White House 

      Let's hope it's an undertaker.

  8. I can't answer that question, and I have asked that myself.  But it is good to hear from you and I worry that the dust bugs under your bed have gotten to you somehow.  I am always a fan of your comments.  Stay well.  

  9. Just to give an idea of how sick our society has become….ponder this!

    Maybe it's me, but when you've got a kid that blows away two people and wounds a third. I don't think there is any circumstance where you should be lauded, especially when you were the one who facilitated that kid getting his hands on a deadly weapon.

    Is it me? Am I wrong to not see what transpired and the approval of such an act as laudable? Sometimes I feel like I've stepped into the twilight zone. America take stock of yourself!

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