On healthcare, Republicans earn deep skepticism
Allow me to bury the lead by beginning with a couple of the usual caveats:
I think it’s perfectly reasonable for people to debate the design, implementation, cost and philosophical principles underlying the Democrats’ Healthcare Reform Act.
A lot of legitimate questions remain about how the program will be paid for long-term, how many people it will actually help, and whether better, less complicated and less intrusive alternatives might be found.
And now for the punch-line: As they seek to score political points on “Obamacare,” Republicans have largely blown their own credibility as the party with the right ideas to answer those questions.
Indeed, GOP leaders have earned for themselves a deep reservoir of skepticism.
The first blunder, of course, is that top Republicans have adamantly refused to offer alternatives, or talk about how they would approach this differently.
Nor have they adequately explained the fact that during the years when Republicans controlled Washington, they ballooned the public costs of healthcare (pushing through a huge, budget-busting prescription drug entitlement for seniors) without addressing the tens of millions of Americans with no insurance coverage.
So when Republicans say their message in 2012 will be “repeal and replace,” journalists like myself and voters like you should be asking for specifics: Replace with what? How will you get it right this time?
The other reason the GOP has drifted into “pants on fire” territory on this issue is that so many of their most adamant claims about the Democratic plan have turned out to be flimsy, exaggerated or downright false.
Just this morning on our airwaves, New York state Republican leader Dean Skelos argued that a new Congressional Budget Office accounting of Obamacare suggests that it will cost twice as much as originally predicted.
This is a widely parroted theme among conservatives and it is, simply and factually, false. Here’s what the non-partisan website FactCheck.org found when they looked at this issue:
Several readers asked us about Republican comments and news reports saying that a new Congressional Budget Office report had found that the federal health care law would cost double the original estimate. But that’s not what CBO’s report said. Instead, the report shows that the gross yearly costs of the new health care law are likely to be 8.6 percent higher than originally estimated.
Politifact — another non-partisan fact-checking team — reached the same conclusion, calling conservative claims bluntly “false.”
Politifact also investigated conservative claims, echoed by presidential candidate Mitt Romney, that the Healthcare Reform Act would somehow ration or deny certain Medicare treatments received by elderly Americans.
Their probe concluded that the assertions were “pants on fire” lies, saying that the a new political ad about the issue “isn’t just wrong. It’s also ridiculous.”
So what’s up with that? If Obamacare really is so toxic, why does the GOP have to keep trotting out full-blown whoppers to attack it? If the truth about the program is ugly, hit us with the truth.
And then there’s the complicated issue of whether or not the GOP’s top candidate, Mitt Romney, actually some of the most controversial policy provisions of Obamacare, while serving as the governor of Massachusetts and while campaigning in 2008.
The Washington Post’s Factchecker site concluded that Romney embraced the idea of personal mandates, insisting as recently as 2008 that “mandates work.”
But Romney never embraced a national mandate requiring that all Americans purchase health insurance.
That’s an important distinction, but it still leaves a lot of of unanswered questions. If mandates work but we don’t want them in national policy, what are the alternatives?
How does the GOP leadership plan to confront the complex, thorny problems posed by uninsured Americans, both those who can’t afford coverage and those who carelessly choose not to buy protection, thus ballooning costs for the rest of us?
As Republicans campaign this summer, these are the questions that they should be answering. And to win the high ground on this issue, they should make sure that their answers are based in fact.
Tags: analysis, election12, health, politics
Claim A: “It is the conservative intention not to go the way of nations who are currently bankrupting themselves.”
This is not in evidence. As another writer points out universal health care in Industrialized societies with better outcomes per dollar spent besides are own are doing just fine.
Claim B: “Watch what happens to them this year and next. Hopefully, we won’t follow suit.”
Ohhh, okay, I see what this writer is saying. Just you wait! You’ll see. Everyone of you Obamacare likers – you’ll see. Nest year or the year after. I would assume that the writer of these beliefs has all the health care that their government position can buy?
Claim C: ” It would be more accurate to say that conservatives want each individual be responsible for their own health care.”
We have yet to read a well thought out and considerate position concerning health care in America from our CONservative brethren other than they seem to be the true Death Panel advocates. You don’t have? Then die! And for that line, Ron Paul recieved a hell ya! and great applause at a repugnant Republican debate.
Could be lots of reasons, but it’s worth noting that their per capita debt is lower than ours. So is the U.K., Canada and Germany– all countries with single-payer health care systems. So how is it that single-payer would bankrupt us?
It would bankrupt us because everyone in those countries who works in health care makes less then those same positions in the US, starting with doctors, insurance executives, nurses, pharma executives and scientists (working on the next generation of viagra and opiates) and so forth.
No one in the Democratic party has started the discussion about taking apart our current system, in fact the current health care law gives everyone more, the government pays for it or it by force mandates citizens to pay for it. That is the reason we can’t afford it , its a scam a give away to the health care industry.
I’m a little late with this but the next time someone calls you “vapid” or something equally derogatory on this blog you should parry with “stick and stones may break my bones but little Lord Fauntleroy words will never hurt me.” Follow that quickly with “I’m rubber, you’re glue (etc)” then pull out “infinity!” They wont know what hit ’em. Works every time.
I’m vamped, vapid and vampired.
JDM drains my brain.
frankjoseph said on March 25, 2012 at 9:10 am:
“JDM, when I asked you for your solution, I fully expected that you would come back with such a vapid response.”
Vapid – lacking taste, zest or flavor, flat; stale.
knuckleheadedliberal – surely you jest, tongue in cheek?
I did not call JDM vapid – I said his response would be vapid. That is not name calling! And, if anything, JDM proved me correct with his word games. Childish behavior also comes to mind.
You have my permission to tell me that what I wrote is silly, stupid, ignorant, dumb, brilliant, correct, incorrect, childish etc., etc., but I appreciate it a lot if you do not apply that lable to me as in Frank is stupid, vapid, etc..
I hope that discriminating readers realize the qualitatitive difference.
Of course you are correct fj.
I was simply trying to point out that JDM was simply looking to find offense in order to avoid engaging in debate. It seems to me that Americans have begun to picture themselves as John Wayne/Dale Earnhardt characters; aggressively rugged individual comic book characters who are full of fear and anger and drive around like maniacs taking offense at the slightest provocation.
Vapid! If someone called John Wayne vapid in a saloon he would have laughed and bought the guy a sarsaparilla.
Walker: “So how is it that single-payer would bankrupt us?”
1) no competition – so there will be no check on premiums
2) as money dries up there will be rationing of services
3) Milton Friedman’s four ways to spend money. The worst is spending someone else’s money on someone else. http://tinyurl.com/6o7952l
khl: “I was simply trying to point out that JDM was simply looking to find offense in order to avoid engaging in debate.”
You wish.
We have rationing now, its just random and based on where you live and how much money you have the insurance you happen to own.
But affordability IS a real issue, we can’t afford government mandated or single payer health care right now. Sure Europe and Canada have done this and indeed even they are having a hard time paying for it. But our health care system is much much more expensive than Europe’s.
Sorry JDM. You are certainly not shy about engaging in debate. What I meant was real debate.
Milton Friedman is a terrible economist in spite of his credentials just as Alan Greenspan was an idiot in spite of everyone going ga-ga over him.
Milton Friedman indeed! Got’s to be kidding? Just like when they are asking to see Obama’s birth certificate.
Naomi Kline’s great book – “The Shock Doctrine: The Rise of Disaster Capitalism” speaks extensively of how Milton Friedman and his AynRand Chicago school of economic thuggery became very influential under President Reagan and PM Margaret Thatcher in Great Britain.
Since 1980, under this Chicago School’s heavy influence, Americans have witnessed the transfer of wealth to the top .01% at a scale not seen since the days of the “Robber Barons” of the late 1800s. Unions have been slowly but surely destroyed and dismantled.
T
The great American middle class has been consistently downgraded, dumb-downed, and “trickeled down upon” by the very wealthy oligarchs who now attempt to run our nation and the world. If only those pesky Occupy Wall Street/Move To Amend people would just shut up and go away!
The best police forces that private money can buy, off-duty NYC cops, have no qualms enforcing their Masters demands to disperse the rebels with brute force, even when not necessary.
I find it hard to believe that we have American citizens, esp. the TeaParty Patriot movement (promoted by Glenn Beck, funded by the Koch Brothers and Dick Armey) which is primarily senior citizens on government provided Medicare/Medicaid – these same good folks want to deny healthcare to other American citizens! Esp. strange to behold are their signs “Keep the Government Out of My Healthcare!”
We are not a truly functioning Republic when we have 40 million of our citizens without proper and government funded healthcare. Even people with insurance were not guaranteed treatment or proper care under the way the insurance companies did business before the ACA came around.
The wealthy will always have their Cadillac insurance policies for use in the best Cadillac hospitals in the world.
“The wealthy will always have their Cadillac insurance policies for use in the best Cadillac hospitals in the world.”
And as providence or coincidence would have it, we learn of VP Richard Cheney’s succesful heart transplant this week. Exhibit A of the above sentence.
godspeed to a swift recovery Mr. Cheney. I pray that your “new” ticker comes from a bleeding heart liberal who opposed torturing people.
You first have to take the Cadillac’s away from the health care industry. This is about affordability more than it is about who pays. Until everyone in the health care industry which now includes about 20% of our GDP, agrees to take less pay and less income; universal health care in the US is simply a fantasy. Politically its like talking about going to mars, sounds good evokes Kennedy, but is not going to happen in our lifetime.
To do universal, government funded health care in the US you have to first re-build our health care industry. Since both Democrats and Republicans are beholden to this industry (which includes the massive private insurance corporations and large drug corporations), the odds are very low it will happen. It is one of the reasons Obama’s plan simply forces people to buy private health insurance, I mean its a great deal for the current system.
We will be lucky to be able to continue to fund medicare and medicaid, that’s the best we will likely be able to do.
“It would be more accurate to say that conservatives want each individual be responsible for their own health care, or health insurance, and in the exceptional case of one who cannot provide for themselves, society will help them out.”
Thats what the “mandate” is about and why it was originally a conservative idea. As it is now, we have an unfunded mandate where anyone seriously ill can go to the hospital and be treated whether they can pay or not. They don’t necessarily get very good care, and they don’t get the cheap follow-up care, but they get treated and they don’t have to pay. Someone else does through taxes or by increasing everyone else’s bill.
I would encourage people who like the French system to look up what the average salary of a French doctor is. It is less than half of what a doctor in the US makes, how many doctors in the US are going to be willing to do that?
Yes we have to get our health care costs down. Thats a different problem, and the excesses are well known. 1) expensive unnecessary procedures , 2) overcapacity in imaging infrastructure, and 3) end-of -life care.
Mervel – many American doctors would be happy with the French system and the French pay scale.
Until now, the conservative mantra has been “We demand the freedom to choose that someone else will pay our (uninsured) medical bills.”
But JDM declares that “…conservatives want each individual be responsible for their own health care, or health insurance, and in the exceptional case of one who cannot provide for themselves, society will help them out.”
This is a very succinct summary of the principle underlying Obama’s reform. So, it would seem, that we conclude this thread in agreement?
“This is a very succinct summary of the principle underlying Obama’s reform.”
Which Obama are talking about?
Obama, as in Obamacare, wants the government to be the single payer of everyone’s medical bills, thereby taking control of who gets services, who does not, and which services they get, and which services they do not get.
Obama, as in Obamacare, wants no one to take responsibility for their own health care needs, rather, as I pointed out, Milton Friedman’s case #4, everyone pays someone else’s money for someone else.
That is the exact opposite of the conservative position.
JDM – you are making stuff up again. Its annoying and not helpful.
“Obama, as in Obamacare, wants the government to be the single payer of everyone’s medical bills, thereby taking control of who gets services, who does not, and which services they get, and which services they do not get.”
Not making it up. Just preparing us all for the reality.
Here’s the current reality: States Rationing Healthcare Under Medicaid http://tinyurl.com/cz7rpd4
Obama said, “you can keep your own provider”
Obama said, “this will keep health care costs down”
Obama said, “your coverage will be the same as Federal government”
Obama said, “unemployment will not go over 8%”
Obama said, “shovel ready jobs”
Talk about making stuff up.
Great that JDM could list all of the very wealthy that are identified with the left and with generous giving and philanthropy of their wealth to humane causes.
Then we have the Koch Brothers who are not.
And, yes, everytime you get called out on some fact that is supposedly in the present, you resort to telling us “this is gonna happen next year or in the future.”
You should qualify your guesses as guesses and not facts currently in evidence.
tinyurls indeed.
Peter,
I see no evidence of that at all. Why do doctors go nuts when the government talks about reducing medicare/medicaid payments? They say they can’t provide ANY services at those rates. Why do so many doctors refuse to take medicaid patients? Do they not like poor people? No of course not, they don’t take them because medicaid does not pay enough.
The AMA will NEVER support the massive pay decreases for doctors that a French style system would require. I am not beating on Doctors, they work really hard and have very high stress and in general do a great job in the North Country in particular. But there is a reason so few doctors go into General Practice.
They are just one small example, to restructure our system along a French style system EVERYONE in health care would make substantially less drug company executives, hospital administrators, not to mention a gutting of the medical malpractice industry. All of these forces have major influence with both the democrats and the republicans.
Maybe someone will be able to force all of these industries to all make less money, but I sincerely doubt it.
In some ways the bigger lie was by the Democrats in saying that you could have universal health care without busting the budget OR radically reforming our current health care industry.
Went to JDM’s tinyurl – it turns out, as I suspected, to be an ultraRight point of view of the world. “THE NEW AMERICAN” – and the top item is STOP OBAMACARE!!!
And this writer wants to be taken seriously when he/she questions sources that do non-partisan fact checking!
Unbelievable hutzpah!
mervel help me to understand you.
After reading through your posts I am a bit confused. You admit that, unlike the French health care system, our present health care delivery system in the United States is broken, taken over by greedy insurance companies, doctors who want to be rich, HMO’s that overbill and over charge fraudulent services, patients not receiving adequate care, 40 million uninsured, more greed and the list goes on.
So we need health care reform.
But we can’t have healthcare reform because of greed, doctors wanting to be rich, etc..?
Sort of a medical Catch 22 as I understand you?
Obamacare or The Affordable Health Care Act will work and people will still have their jobs in the massive and greedy health insurance companies.
Are you also reading at the New American website?
And once again, merval and JDM, you guys have spent a lot of time here criticising Obamacare and the Democrats/liberals, which is fair enough and your right as a fellow American.
But, where oh where can we find any offer of a solution from the CONservative wing?
We do need our Jeremiahs weeping tears about the coming disaster of Obamacare, but where are our Republican Solomon’s offering wisdom and solutions?
Not in evidence thus far. And that is the whole point of Brian Mann’s article.
Mervel, re: American doctors accepting the French system, I have seen a number of doctors quoted as saying that they would be happy with a medicare-for-all approach, because it would end the cost and headaches of dealing with hundreds of different health policies.
You’ve written more than once that first we have to find a way to reduce doctor’s salaries, etc., before we could go to single-payer. That makes no sense. We have to adopt single-payer first, and then reduce costs. You think French and British doctors salaries were substantially lower than ours before they adopted a single-payer system. Part of the reason our costs are so high is that we have become a haven for all of the world’s greediest doctors.
You write “The AMA will NEVER support the massive pay decreases for doctors.” But many doctors feel that the AMA doesn’t speak for them.
Mervel – Medicare pays below-market prices and below cost of delivery. Private insurance companies pay medicare plus some percentage (depending on insurance company). The doctors can take only so many medicare patients depending on the rest of their patients and the insurance companies they belong to.
The younger generation of the AMA is getting behind the affordable health care act (obamacare) for a lot of reasons, but mainly because they can care for more patients and worry less about billing and who has insurance and who doesn’t. As part of my job I interview perspective medical students for admissions. Universally, they recognize that they will be making less money than their predecessors and are all more than ok with that. Most are also in favor of Obamacare.
prospective
Some of the conservative solutions that have been put forth are health savings accounts, tort reform, and mandate reform.
The reason they receive little attention is because they seek to fix the problem, rather than create a bigger government whose existence relies on the problem not ever being solved.
Meanwhile, libs like to demagogue the issue with phrases like, “the conservatives have no solutions”.
Hopefully, the Supreme Court will strike down Obamacare in toto, and we will get a chance to see some real health care reform take place in the coming years after Obama.
JDM, how much good do you suppose a health savings account is going to do a minimum-wage worker who runs into a $500,000 medical bill?
Tort reform would reduce a physician’s insurance costs marginally, but it’s not going to solve the problem of millions without health insurance.
Mandate reform? That helps how?
See, this is why saying that “the conservatives have no solutions” is a straightforward statement of fact. How is it “demagogue the issue”?
As long as we are complaining about being forced to buy health insurance, shouldn’t we also be complaining about being forced to buy car insurance?
Malpractice insurance used to be a big cost driver – no more (everything else got bigger in comparison) – tort reform would be useful but wouldn’t do too much. Insurance across state lines – another conservative idea – wouldn’t do much either, and might well be counterproductive – monopolistic. Doctors salaries and other labor costs aren’t a big driver either, so reducing their salaries doesn’t do much.
The only way to cut costs is some form of rational rationing. Hopefully “evidence-based” i.e.. a new procedure has to be shown to be useful (and maybe better than something that costs 1/10th as much) before the insurance companies have to pay for it.
Farnkjoseph,
I don’t believe Doctors are greedy in the US, I do think that many have to charge what they do because of the costs that they must bear, starting with the crushing debt of medical school and continuing with the massive insurance premiums they must pay for liability insurance. French doctors worry about neither of those things. The average doctor in France makes between 40-70k US, per year, about the same as many experienced teachers in NYS, and about the same as most RN’s in the US.
Let me be clear I would favor the French system, I find what the Democrats and the Republicans have offered as scams. Both exist in fantasy land.
I’ve heard this arguement before and over and over again regarding the conservative healthcare “solutions” of tort reform and health savings account. To address the latter first, I thought that the President handled this issue most appropriately during the roundtable. When a Republican senator present (whom was also a doctor) made the opening statement for them and basically said that their solution is for everyone to be only offered a health savings accounts and catostrophic coverage, that this is what he himself (the Republican senator) has. The President asked him if he would feel the same way if he was making $40,000 per year instead of the $170,000 per year that congressmen and senators make. Someone making $40,000 or less a year is not going to be able to afford a healthcare savings account. Sorry. I’m in this demographic, and I can’t even afford a regular savings account, so, I’m speaking from experience. And it is not this demographic (those making $170,000 or more per year) for which health care reform is intended. There is also this false notion that tort reform will decrease health care costs. Prior to the debates, Republican Senator Orin Hatch of Utah went to the non-partisan Congressional Budget Office, convinced that the tort system in place was a major component in our health care costs. What the CBO determined was that this component is in reality one-half of one percent of health care costs in this country. That’s the fact. Tort reform will not do squat to lower health care costs in this country or increase better outcomes. Also, I don’t know about France, but the doctors in Canada and the U.K. do just fine, and if you ask one of those doctors or even an ordinary citizen if they would like to switch to our sytem of providing care from theirs, the response (after a good ol belly laugh) is a resounding “No”. That’s a fact too. For evidence, please see said doctors interviewed in the documentary “Sicko”.
Walker: Since you pooh pooh my list of solutions, perhaps you could enlighten us with a few that you think would work.
By the way, Walker, I un-pooh pooh my list. I don’t consider you the arbritrator of pooh pooh.
I’m not pooh poohing your “list”, I’m saying the items on it are useless. You explain how someone living on $20,000 a year is going to be able to use a health savings account. I might as well say the Good Health Fairy will solve all our problems.
And if you have read my comments at all, you should know that my preferred solution is a single-payer system, like France or Canada.
Mervel, incidentally, I didn’t say “Doctors are greedy in the US,” I said the U.S. is a magnet for greedy doctors. There are plenty of doctors in the U.S. who just want to do a good job for a reasonable compensation. And of course the fact that health insurance companies are skimming 20% off of every health care dollar is not helping things at all.
Tort reform is a big thing. It has many facets. It cannot be dismissed in toto. It is part, a big part, of the problem.
Health savings accounts are not the entire solution. They represent a turning from Milton Friedman’s category #4 to category #1 (using your own money to spend on yourself). A big improvement (khl’s pooh pooh notwithstanding)
Mandates are another big part of the problem, and add up these three together, and there is some real chance of reform.
Come on, Supreme Court! Put the ball back in play!
I do think doctors in Canada do just fine I don’t know how US doctors would feel? I don’t see many US doc’s heading over to France or moving to Canada, I do see the inverse though.
Doctors are just a small part of the puzzle, and the solution cannot simply come out of their paychecks, although that will be a part of it. You are talking about the drug industry, the insurance industry, the medical devise industry and so forth. Are all of these industries willing to voluntarily accept lower revenues and incomes? How do you do that and still provide a supply of health care. Many doctors if forced to take current medicaid or medicare rates of insurance have said they would simply leave the field that they can’t afford to do that. Yet the rates they would get under this new law would be even lower? How will that work?
We always want something for nothing in this country, always looking for the easy solution. Health care reform WILL require pain in the health care industry and will require pain among the patients who are used to demanding care.
Well, I don’t get on here too often, but I have to say that (unlike our congress) it is an uncommon honor and privilege to have an open debate and discussion with people I disagree with on such an important issue without mud or slings or arrows being slung. So I appreciate that.
You know, in closing, it goes back to my earlier point referencing the fire and police department and whether or not you consider health care to be a fundamental human right. If you do not, then there is nothing I or anyone else will be able to say to convince or change your position.
Regarding tort reform, that one-half of one percent as it relates to overall health care costs in this country is a real number and available for review on the CBO’s web site. It is NOT a big thing (or even a small thing) as it relates to overall health care costs. I would also implore one to think about how they would feel if due to genuine negligence, a dear loved one was maimed for life, and the most he or she could get for their lifetime of pain and trouble as a result was say $100K. There’s more to this issue than the money.
I too am familiar with Friedman and his economic therories. But if you’re looking at this issue strictly from an economic standpoint, and not a human rights standpoint, as I do, then what Friedman has to say doesn’t really hold much water with me on this topic.
I will come back in June, but in the meantime I will make the prediction to everyone here and now that the Supreme Court is not going to overturn this Act. It’s too important, and too useful, and the benefits have already been felt by too many.
It does not do any good to present CBO facts, independent think tank facts, or facts that have been vetted through one of several very good fact checking sites.
No, as you can see, despite using rational and logical thought processes, explaining the facts behind why tort reform is just a tiny “url” of this picture (but not according to THE NEW AMERICAN) and why it is nearly impossible for people making under a hundred k a year to pay for their own “voucher” system or what-have you, and why, for a fact Canadians like there health care system, the debate goes around and around and around with one side seemingly in complete denial of the facts while hoping and praying that the U.S. Supreme Court collectively (at least 5 anyway) believe as they do as well.
It really becomes pointless to have any further discussions. Again, pointing out problems, real or imaginged, as JDM does here is not offering a solution. Other than just wanting to see the “baby thrown out with the bath water.”
Mervel writes “Are all of these industries willing to voluntarily accept lower revenues and incomes?”
Who said anything about voluntary? You pass the law. That’s it.
Is the auto industry voluntarily raising fuel efficiency standards? No, we passed a law imposing the CAFE standards. If we pass a tort reform law, will lawyers voluntarily limit the damages they can collect? No, the law will limit them. [Granted, our congress is so close to being owned and operated by those with cash that it’s hard to imagine such laws being passed. That’s why we need to overturn Citizen’s United.]
earlier mervel wrote:
of course no one can say for sure what effect the aca is going to have on health care costs until we’re well past 2014, but otherwise this just isn’t right. the aca is chock full of cost reforms to the system. have a looky at this wonkblog post. some key quotes:
you can still argue that the aca doesn’t go far enough, that its reforms are too timid, and you’d get a sympathetic ear from me! but i think it’s a genuine step in the right direction. and i also think that it’s about as good a deal as our government is capable of producing. i’d love to scrap the current insurance system and put single payer in place as much as anyone else, but that’ll never happen, not with all the jdm’s around. incremental change is the way to go.
“How is it that they can provide for all their citizens, and we cannot?”
One thing they have is what we don’t. What some might call Comprehensive immigration reform. They know that if they want to do this they cannot have borders that are Swiss cheese like we have in the US. I lived in France for several years. If you don’t like the Arizona immigration laws don’t put France on a pedestal. In France if you don’t “look right” you may get detained. Do we want that here? Maybe.
The place to start is ask folks what they will pay for health care. We know what they are willing to pay for a good smart phone or a flat screen TV despite the fact that they probably cannot afford either in many cases. Would they give those up for health insurance that they really should have? The problem is that peoples priorities are screwed up these days.
can i also just say how friggin awesome jdm’s 10:05 post is?
peter hahn and mayflower both (correctly) point out that the aca accords very nicely with the vision for conservative health care articulated by jdm. in response, he launches into some kind of fever dream version of what he just knows obama really wants to do with health care, never mind the fact that none of it has anything to do with the law that was actually passed. it’s toys-in-the-attic crazy.