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[Ed. Note: To see exactly what this former Reagan insider has to say about Trump and the fiscal threats from politics and the debt ceiling, David Stockman is sending out a copy of his book Trumped! A Nation on the Brink of Ruin… And How to Bring It Back to any American willing to listen – before it is too late. To learn how to get your free copy CLICK HERE.]
It’s all over except the shouting, and I’m not talking just about Ryan’s “repeal and replace” washout.
I mean the whole fantasy of the Trump Reflation trade and Wall Street’s delusional view that the massive financial bubble now enveloping the casino can be kept afloat indefinitely because Washington will always come through with whatever “stimulus” it takes.
The idea that there is an actual working GOP majority and that some pro-growth policy juggernaut is coming down the pike has always been a case of the wish being father to the thought.
After all, the present day Republican party is such a fragmented gang of factions that it couldn’t even nominate a presidential candidate. What remains of the party got mugged by a rank amateur and insurrectionist.
He won only because Flyover America is desperate economically; but the Donald offered no coherent program at all.
Among other things, that’s why today’s non-vote came down to the wire at all. The campaign was all noisy demands for “repeal,” but hardly more than a few random tweets about “replace.”
So there is no GOP consensus or public mandate at all about the hard part of replacing Obamacare. Trump himself had no ideas except eliminating interstate barriers to insurance sales, but that assumes there are customers.
There are not. Roughly 275 million people are hostage to Medicare, Medicaid and employer group plans, which alone include about 160 million beneficiaries.
But those are giant pre-payment pools where insurance competition doesn’t matter; coverage structures are rigidly “one size fits all” within each of the big pools; and, perhaps most importantly, what passes for the health care “market” is just a bureaucratic clearing house where provider cartels attempt to maximize their billings — while insurance companies, HMOs, PPOs and utilization review and pre-approval agencies seek to minimize what they certify for payment.
Under those status quo arrangements, there is absolutely no way to get what most of the GOP professes to want, especially the conservatives.
Namely, lower insurance premiums, reduced entitlement program costs, greater delivery system innovation and flexibility and more consumer empowerment and choice.
Those good things can only happen when a meaningful share of the above-mentioned 275 million participants are liberated from the inherent collectivism of third-party payment pools and, instead, are given the cash equivalent to shop the hell out of the medical service delivery and insurance coverage system.
Then “competition” would be electrified, thousands of differentiated health plans would bloom and pricing would become individual cost-based.
Then too, the relief from soaring Obamacare premiums that the Freedom Caucus demands could be …read more
Source:: Daily Reckoning feed
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