Thursday, April 6, 2017

Trumpcare: a "systems" approach?

Scott Adams has some interesting thoughts on the future of healthcare reform, and what he sees as President Trump's "systems" approach to the problem.

The quick summary is that a system is something you do on a regular basis that improves your odds of success in a non-specific way. Systems-thinkers choose paths that allow them to come out ahead in the long run even if they appear to be “failing” along the way.

. . .

As a systems-thinker, I don’t see the first attempt at a GOP healthcare bill as a failure. I see it as part of Trump’s normal systems-thinking approach. The tell for a good system is that failure puts you AHEAD. And that’s exactly what happened.
By the way, I told you during the campaign that one of Trump’s signature moves is creating two ways to win and no way to lose. He did that again with healthcare. Here were his two ways to win:

1. Healthcare bill gets passed on the first try. Trump looks like an effective leader. The details of the bill get improved over time.

2. The healthcare bill does NOT pass on the first try. This softens up the far right by branding them villains. Now they have to compromise on the next bill or watch as centrist Democrats enter the conversation. Meanwhile, the clock is ticking on Obamacare, and the conditions for compromise are IMPROVING EVERY MINUTE. That’s what the Master Persuader tells us happens when you “walk away from the table” like you mean it. Trump just walked away from the table to go work on tax reform. If you watch his Twitter feed, you know he is winking at the public and telling us to stay tuned on healthcare.

Meanwhile, a fascinating thing is happening outside of government. Watch how many private citizens are looking into the details of healthcare reform and even proposing their own solutions on blogs and articles. The nation is engaged on the topic in a way that looks like a self-organizing system. All the public needs is some sort of common website that is designed to discuss the pros and cons of the various ideas in plain language so the best ones can bubble up to the top.

. . .

I don’t like living in the “can’t do” country. If Congress can’t get healthcare fixed, the public appears ready and willing to fill the gap.

There's more at the link.

This is an interesting perspective.  Is it possible for public opinion to bypass the logjam of Congressional and Senatorial politics, and come up with a solution to a national problem that's crowd-sourced, rather than forced upon us by lobbyists and special interests?  I don't know . . . but if it is possible, it should be feasible in more areas than just health care.  That opens up all sorts of interesting and intriguing avenues, and a far more participatory future for democracy.  Might the smartphone and other forms of mass communication usher in the era of "instant referendum" politics?



B said...

Simple solution:


No One Owes Anyone Health Insurance.

Until that fact is held true, the system is set up to fail.

Anything else is unacceptable. The RNC boys and girls ran on a platform of repeal. Time to honor that promise.

Anonymous said...

The public has the means to fix national issues. It's called the "market" and it works well if allowed to do so. Obamacare, and several decades of state and federal regulation have severely restricted the market, warped it, damaged it. The regulations were designed to do just that, to the benefit of crony insurance businesses.

Repeal the regulations. If you're going to strengthen regulations, aim for contract law. Make it harder for insurance companies to weasel out of contractual obligations and control the use of "fine print".

Mark Matis said...

I would merely note that the "Freedom Caucus" had the ability to remove Lyin' Ryan from the Speaker position for this Congress, and they refused to do so. A small number of them did indeed take a stand, but the caucus as a whole did jack shiite. That means they FORCED President Trump to deal with the treasonous POS. And then they, and their supporters, have the temerity to bitch when President Trump calls them out for their actions? May every one of them burn in hell where they belong. Along with the Rove Republicans and the Democrats as well.

ronehjr said...

"....Centrist democrats". Is this piece from 50 years ago.

Anonymous said...

And the consensus is....well isn't that is what the left always says? That we need a dialog and then come to a consensus?
So if a thousand monkeys and a typewriter can create a Shakespearen play......why couldn't a million humans create a workable solution to health care!?!?!?!?


Quartermaster said...

There is no such thing as a Centrist DemonKKKat They're all hard leftists. Much of the GOP is anything from hard to moderate left. Only the Freedom Caucus approaches being centrist.

If trump involved those supposed centrist DimoKKKRats, he'd might as well hang the rest of his term on the hook, because it's over.

Anonymous said...

The discussion portion has not yet ended, so it's difficult to determine what the action plan will be.

Choice 1: Medical insurance
Choice 2: Medical services paid by someone else
Choice 3: You're on your own.

Medical insurance is what it sounds like: an insurance plan that operates like automobile insurance and homeowners' insurance - reasonable protection against catastrophic expense but nothing toward daily routine maintenance. And, just like homeowners' insurance has different aspects of coverage (Florida needs hurricane damage coverage but Montana doesn't) with different coverage costs and deductibles, so should medical insurance.

Medical coverage paid by someone else is what was actually delivered when everyone advertised medical insurance. We have WWII federal government price and wage controls to thank for this, another example of why the fed dot gov should be herded back into its Constitutional corral.

You're on your own is the Democrat Party's raison d'etre for existence to prevent. Any instance of individual responsibility is to be crushed and the word "fair" bandied about recklessly to demand universally-applied, ridiculously expensive incompetence funded by anyone with more money than the poverty level.

One might say the better solution - there is no "ideal" or "best" one - is a cafeteria-style offering, available everywhere to everyone without restriction where the individual selects the coverage, both in type and degree, best suited to their particular need. Crowd sourcing might be able to do this better than the zombies on Capitol Hill, especially if the Crowd can drag state legislatures along.

Separate the delivery of medical services from how that delivery is paid for with an impenetrable wall because they're two completely different things. It's not unreasonable to provide some assistance to the financially infirm - we're not a country that lets people suffer because they're short a few bucks, nor should we be - but at the heart of that discussion and the resultant action should be complete price transparency for medical services; if I'm charged with making, or perhaps just "allowed to," my own decisions on medical services, I should have clear and simple access to what a particular medical service offered by a particular service provider entails and exactly what it will cost. I comparison shop auto and home repairs and when I find a suitable mechanic or contractor I don't give him a blank check, why should my doctor get one?


Tim Newman said...

Separate the delivery of medical services from how that delivery is paid for with an impenetrable wall because they're two completely different things.