I wrote on Wednesday that Republicans forced themselves into a corner with seven years of lying and overpromising about healthcare. The fact that nothing they do now will live up to the promises they made before is a big political problem.
- Trump doesn’t really care what the bill does, exactly, so long as he can sign it and say that it “repeals and replaces” Obamacare.
.. You don’t walk into a negotiation and tell your counterparty that you’re desperate to make a deal fast and on any terms. But Trump did just that, which is why Freedom Caucus members knew the White House was bluffing when it claimed the bill was closed and wouldn’t be amended further.
.. Trump might be making such promises. But because he has a decades-long reputation for reneging on his promises to counterparties, members are unlikely to trust Trump when he does so.
.. Trump’s assurance that the bill’s limitations — for example, its limited impact on insurance regulations under Obamacare — will be addressed through executive action and future legislation do not seem to be convincing enough of his party’s own representatives to get this bill passed.
.. Trump seems to have been personally unprepared for the interconnected nature of healthcare policy. Moving the wrong piece can cause the healthcare market to crash down like a Jenga tower, and Trump has no idea how to determine which blocks are loose.
.. if you’re going to repeal EHB, you also need to repeal Obamacare’s rule that requires insurers to cover preexisting conditions, as otherwise insurance markets could collapse.
.. If Trump understood health-insurance policy (or asked someone who did), he would have known that EHB rules and preexisting-condition rules go together like peas and carrots, and he shouldn’t offer to repeal one if he’s dead set on keeping the other.
.. Trump shifted the focus of his professional endeavors away from businesses that were heavy on dealmaking and toward businesses that were heavy on marketing, particularly arrangements in which he would rent his name to somebody else who was actually in the business of developing real estate.
Health Care Bill’s Failure: Just Part of the ‘Art of the Deal’
The most difficult faction to deal with is the Republican establishment — not because they are politically strong, but because on policy issues like health care, they are convinced that they have all the answers and that Trump just does not understand.
.. he exposed two things about them: first, that they had not come up with a plan that was ready for prime time; second, that they had not done any of the political legwork necessary to sell their plan to voters.
.. Whereupon Trump will turn to the moderate Democrats and offer them a deal — perhaps catastrophic health coverage in exchange for repealing Obamacare.
.. Democrats would take that deal because they would see a government-backed catastrophic insurance system as a possible path to the universal health care system of their dreams. Republicans would take that deal — after exhausting all of the other options — because it would leave enough room for the free market to provide insurance for most health issues, and for states to experiment with their own policies.
Book Review: The Art of the Deal
Since its publication, he seems to have spent his time directing an institute to spread awareness of techniques for success and persuasion. At the risk of being a little too cynical – a guy knows the secrets of success, so he uses them to…write a book about the secrets of success? If I knew the secrets of success, you could bet I’d be doing much more interesting things with them. All the best people recommend Cialdini, and his research credentials are impeccable, but I can’t help wondering: if he’s so smart, why isn’t he God-Emperor?
.. Trump: The Art Of The Deal is 365 pages of some of the biggest print I have ever seen.
.. Although the blurb says that he “fully reveals the deal-maker’s art” and that it is “an unprecedented education in the practice of deal-making” and “the ultimate read for anyone interested in achieving money and success” – only seventeen pages of very large print are anything resembling business advice. The rest of it is a weirdly deal-focused autobiography that doesn’t mention marrying his wife or having children, but devotes a lovingly detailed twenty-four pages to the time he renovated the Commodore Hotel.
.. Instead, when a reporter asks me a tough question, I try to frame a positive answer, even if that means shifting the ground. For example, if someone asks me what negative effects the world’s tallest building might have on the West Side, I turn the tables and talk about how New Yorkers deserve the world’s tallest building, and what a boost it will give the city to have it again. When a reporter asks why I build only for the rich, I note that the rich aren’t the only ones who benefit from my buildings. I explain that I put thousands of people to work who might otherwise be collecting unemployment, and that I add to the city’s tax base every time I build a new project. I also point out that buildings like Trump Tower have helped spark New York’s renaissance.
The final key to the way I promote is bravado. I play to people’s fantasies. People may not always think big themselves, but they can still get very excited by those who do. That’s why a little hyperbole never hurts. People want to believe that something is the biggest and the greatest and the most spectacular.
I call it truthful hyperbole. It’s an innocent form of exaggeration – and a very effective form of promotion.
.. As best I can tell, the developer’s job is coordination. This often means blatant lies. The usual process goes like this: the bank would be happy to lend you the money as long as you have guaranteed renters. The renters would be happy to sign up as long as you show them a design. The architect would be happy to design the building as long as you tell them what the government’s allowing. The government would be happy to give you your permit as long as you have a construction company lined up. And the construction company would be happy to sign on with you as long as you have the money from the bank in your pocket. Or some kind of complicated multi-step catch-22 like that. The solution – or at least Trump’s solution – is to tell everybody that all the other players have agreed and the deal is completely done except for their signature. The trick is to lie to the right people in the right order, so that by the time somebody checks to see whether they’ve been conned, you actually do have the signatures you told them that you had.
.. Here is a guy whose job is cutting through bureaucracy, and who is apparently quite good at it. Yet throughout the book – and for that matter, throughout his campaign for the nomination of a party that makes cutting bureaucracy a big part of their platform – he doesn’t devote a lot of energy to expressing discontent with the system. There is no libertarian streak to Trump – in the process of successfully navigating all of these terrible rules, he rarely takes a step back and wonders about a better world where these rules don’t exist
.. So when he says that he’s going to solve Medicare by hiring great managers and knowing all the right people, I don’t think this is some vapid way of avoiding the question. I think it’s the honest output of a mind that works very differently from mine.
.. The best he can do is say that other people are badat governing, but he’s going to be good at governing, on account of his deal-making skill. I think he honestly believes this. It makes perfect sense in real estate, where some people are good businesspeople, others are bad businesspeople, and the goal is to game the system rather than change it. But in politics, it’s easy to interpret as authoritarianism – “Forget about policy issues, I’m just going to steamroll through this whole thing by being personally strong and talented.”