Tom Price Nominated for HHS Secretary. So Long, Obamacare! Bye, Medicare! Au Revoir, Medicaid!

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Good luck with those health-care vouchers, folks!

I’m going to port over about four paragraphs of this critical new article by David Dayen in the Nation and encourage you to read it.  Not much more needs to be said, except that we have accidentally elected what will be the most conservative administration in 90 years and now we’re on a path to take a look at what life was like in 1926.  The long-predicted demise of the New Deal and Great Society social programs is upon us.  Dithering and dissembling Donald Trump is going to be used as the front man for a movement that wants to bring back massive desperation among the elderly and the poor as a means of cramming down public demands for justice — because make no mistake about it, these voucher plans will not work.  They’re not SUPPOSED to work.  They’ll just lead to inflating the prices of medical care beyond what coupons provide — and don’t make me laugh about how prices will be kept down by “increased competition” in a world without anti-trust law.  They’re supposed to make rich people more money — and that they will do.  Here’s Dayen, though the emphasis is mine:

For those who thought Donald Trump, someone who spent two years on the campaign trail promising to protect programs like Medicare, might consider keeping that promise, let today’s news disabuse you of that notion. The selection of Georgia Congressman Tom Price as Health and Human Services Secretary offers the clearest signal yet that Trump and House Speaker Paul Ryan are perfectly aligned, and ready to make Medicare phase-out the signature proposal of his presidency.

There’s not much daylight between Ryan’s and Price’s plans for the nation’s health system. Both want to repeal Obamacare; in fact, Price has issued a detailed replacement plan every year since 2009, before the ACA even passed. Price’s Empowering Patients First Act contains the usual features of conservative health-care plans—poorly funded high-risk pools for anyone rejected for a preexisting condition, letting insurers sell across state lines, health savings accounts, tort reform, and capping the tax exclusion for employer health coverage. Practically all of these ideas have been implemented either at the state level or during George W. Bush’s administration, and none succeeded in closing the uninsured gap or making health care cheaper. But Price’s major provision replaces the ACA with a meager tax credit to purchase private insurance on the individual market. It also allows people to opt out of Medicare or Medicaid and take the tax credit.

If that sounds familiar, it’s substantially the framework of Ryan’s premium-support plan to convert Medicare into a coupon for people to put toward insurance. Price has endorsed the Ryan plan: Earlier this month he saidCongress would phase out Medicare in the first six to eight months of 2017. He even laid out how to get it done while avoiding the filibuster. Using budget reconciliation, fiscal items that don’t increase the deficit outside the 10-year budget window can get an up-or-down vote with limited debate.

Price succeeded Ryan as House Budget Committee chair, so he understands the mechanics of the process. And he would have to do something fast, because a full Obamacare repeal, including the Medicare provisions, would immediately reverse the ACA’s extension of the Medicare trust fund, triggering an inability to pay all benefits within the first year or two. So Price and Ryan would create an unnecessary crisis in Medicare to get to their favored solution of voucherizing it.

For good measure, Price’s last budget not only repealed Obamacare but turned Medicaid into a block-grant program for the states.

This is about much more than the Rube Goldberg–system of the ACA. Price’s ambitious blueprint would roll back two of America’s biggest social-insurance programs. Prior to Congress, he was an orthopedic surgeon, the kind of high-priced service provider that stands to lose from a universal system that wrings costs out of specialist fees. He has no interest in social insurance, and his top priority at HHS will be to cripple anything resembling it. And to sell Trump on the whole shebang.

There’s much more.  Read it.  And expect the same withering eye to be cast on these policies as is cast on the happy-talk “funneling more money into the Resort District will help everyone” chatter that most of us despise.  This is magnitudes bigger — and if you’ve been induced to care about the local kleptocratic pillaging of the poor and infirm but not the coming national one, then it’s time to take stock of things and consider whether you’ve been bamboozled.

Hint: you have.  We all have.  Had Trump run on this platform instead of steadfastly rejecting it, he’d have lost — bigly.