a cut of taxes that are painless to the small percentage of people who have to pay them — a 0.9 percent Medicare surtax, and 3.8 percent tax on net invested income for couples earning more than $250,000 a year.
.. And it’s not as if there’s been a great hue and cry to repeal those tax increases. “My wealthy clients barely noticed the taxes resulting from the Affordable Care Act and have not needed to make lifestyle adjustments,” wrote the Forbes contributor Carolyn McClanahan, a financial planner.
I bet if you asked rich people if they wanted to cut off health care for millions of their fellow citizens in exchange for a bit more money at the end of the year, most of them would say no, that’s crazy. Taxes don’t register among the top concerns of people, in poll after poll.
Why such a cruel bill, then?
.. “We’re talking about a great, great form of health care,” President Trump said at midweek, with all the conviction of someone peddling the fraud of Trump University.
And you have a Congress that was largely paid for by influential groups for whom tax cuts are the only reason to get out of bed in the morning. Still, we have a moment of rare consensus in this country: An overwhelming majority hates the Republican overhaul. No state in the union has voiced majority support.
Understanding Republican Cruelty
The basics of Republican health legislation, which haven’t changed much in different iterations of Trumpcare, are easy to describe: Take health insurance away from tens of millions, make it much worse and far more expensive for millions more, and use the money thus saved to cut taxes on the wealthy.
.. Meanwhile, taxes that fall mainly on a tiny, wealthy minority would be reduced or eliminated. These cuts would be big in dollar terms, but because the rich are already so rich, the savings would make very little difference to their lives.
More than 40 percent of the Senate bill’s tax cuts would go to people with annual incomes over $1 million — but even these lucky few would see their after-tax income rise only by a barely noticeable 2 percent.
.. So it’s vast suffering — including, according to the best estimates, around 200,000 preventable deaths — imposed on many of our fellow citizens in order to give a handful of wealthy people what amounts to some extra pocket change.
.. I think there are two big drivers — actually, two big lies — behind Republican cruelty on health care and beyond.
First, the evils of the G.O.P. plan are the flip side of the virtues of Obamacare. Because Republicans spent almost the entire Obama administration railing against the imaginary horrors of the Affordable Care Act — death panels! — repealing Obamacare was bound to be their first priority.
.. Republicans, through their political opportunism and dishonesty, boxed themselves into a position that makes them seem cruel and immoral — because they are.
.. this story began with a politically convenient lie — the pretense, going all the way back to Ronald Reagan, that social safety net programs just reward lazy people who don’t want to work. And we all know which people in particular were supposed to be on the take.
.. What it does — punish the poor and working class, cut taxes on the rich — is what every major G.O.P. policy proposal does. The only difference is that this time it’s all out in the open.
.. remember this moment. For this is what modern Republicans do; this is who they are.
Golf Clubs Get Real Estate Tax Breaks based on
If you change the boards of a ship one plank at a time, and replace all boards, is it the same ship?
- Ship of Theseus, described by Plutarch
- meriological: identity is sum of its parts
- Spacial Temporal Continuity: the ship moves smoothly through time. There is no point in time when you can say you have a new ship
- but what if you steal the ship piecemeal?
- the problem is unresolvable, only resolvable by using some external principle
The Republicans’ War on Medicaid
as incomes have stagnated and health-care costs have accelerated, Medicaid has turned into an essential support mechanism for millions of Americans who can’t be classed as poverty-stricken, strictly speaking, but who also can’t afford to bear the costs of private health coverage.
.. 74.6 million people were enrolled in plans supported by Medicaid or its sibling, the Children’s Health Insurance Program. That’s more than one in five of the U.S. population.
.. sixty per cent of all nursing-home residents now receive some sort of assistance from Medicaid.
Kids are also big beneficiaries: Medicaid and chip now help to provide medical coverage for about a third of all the children in America.
.. the Party doesn’t merely want to roll back the Obamacare reforms; it wants to shrink the entire program, transferring it to the states and imposing tight caps on the payments they receive from the federal government.
.. the bill would reduce over-all federal spending on health care by about $1.1 trillion over ten years. Of that,
- eight hundred and thirty-four billion dollars—fully three-quarters of the savings—would come from cuts to Medicaid.
.. spending on Medicaid would be reduced by a quarter compared to current spending. In the same time period, the number of people covered by Medicaid and chip would fall by about fourteen million
.. Donald Trump appeared to understand this when, from the beginning of his campaign, he promised not to cut Medicaid.
.. If you view the modern G.O.P. as basically a mechanism to protect the wealthy, Medicaid is an obvious target for the Party.
.. recent expansion was financed partly by an increase in taxes on the richest households in the country.
.. They also dislike that it’s working. As medical costs have risen and the private sector has failed to cover an increasing number of Americans, the Medicaid and chip programs have filled some of the coverage gap, and have done so relatively cheaply.
.. For any politician who loathes government interventions in the economy, and whose real goal is to head off socialized medicine, the expansion of Medicaid represents a serious threat.
.. Here is an embryonic single-payer system that is growing fast and could be further expanded pretty easily. That means it has to be crippled now, before it gets more firmly established.