Republicans are be divided with or without Trump

(Michael Vadon/Wikimedia)

As Republican delegates get ready to head to Cleveland for the party’s convention next week, the debate has shifted to whether party members should follow the will of Republican voters and anoint Donald Trump as the Republican nominee or whether they should act as a failsafe device and reject the unpopular choice of the voters for another candidate. Trump supporters argue that such a move would divide the GOP and make a Hillary victory inevitable. In reality, Donald Trump has already divided the Republican Party and almost definitely assured a Hillary win.

Donald Trump’s candidacy in and of itself has divided the Republican Party as no (other) Democrat could ever hope to do. Trump’s unpopularity is no longer news. The businessman’s most notable political accomplishment, aside from becoming the presumptive nominee, is making Hillary Clinton look good by comparison.

Trump’s unfavorable rating has consistently hovered in the 60 percent range according to Real Clear Politics, worse than Hillary’s approval, which itself is nothing to brag about. A New York Times poll found that Trump is considered less trustworthy than Hillary, again no mean feat, and his values are shared by fewer voters than are Hillary’s values.  

Fundamental problems with Trump’s character are causing his base to splinter. The same Times poll reports that “three in ten voters who supported other Republican candidates” say that they will not support Trump in November. A more recent CNN poll found that 48 percent of Republicans would prefer that the GOP choose someone else as its nominee. NBC News and the Wall St. Journal found even more Republicans dissatisfied with Trump at 52 percent.

Prominent Republicans such as George Will, Max Boot and Hank Paulson have announced their intention to support Hillary over Trump. CNN recently reported on a grassroots “Republican Women for Hillary” movement. Even former First Lady Laura Bush has hinted that she may support Clinton over Trump.

The Republican Party is clearly divided over Donald Trump. In contrast to Trumps -30 percent net approval rating, by July 2012 Mitt Romney, another unpopular candidate, had an approval rating that broke even on average. Romney also worked hard to unify the party against President Obama and the Democrats. Trump’s attitude has been one of “my way or the highway.” Trump backer Sarah Palin has even taken to calling Trump opponents “R.A.T.’s,” an acronym for “Republicans against Trump.”

Perhaps related to Trump’s personality problems are his strategic problems. Traditional GOP donors are not rallying behind Trump. USA Today reports that the Team Trump has only $1.3 million on hand compared to $42 million for the Hillary campaign. Hillary’s campaign staff is 10 times larger than Trump’s and, according to Politico, Trump campaign staff in battleground states is almost nonexistent. 

All of the above has contributed to a growing revolt against Trump. The Wall Street Journal reported last week that anti-Trump activists were close to gaining enough votes at the convention to unbind delegates. A federal ruling on Monday held that Virginia delegates could not be required by state law to vote for the winner of their state primary. As Trump’s erratic behavior continues, it seems that struggle for the nomination will be completed on the convention floor.

The bottom line for Republican delegates as they get ready to make their way to Cleveland is that they are caught between the proverbial rock and the hard place. If Donald Trump emerges from the convention as the nominee, a large number of Republicans are likely to sit out the election or vote against Trump. With a fragmented base and support cratering among Hispanics, blacks and women (where he trails by 17 percent), Trump seems to destined to lose if he is formally nominated. There simply aren’t enough Republican voters in the white male demographic, the only segment of the electorate that seems to favor him, to allow Trump to win.

On the other hand, if convention delegates are able dump Trump, the party will be split along different fault lines. Trump’s core supporters will likely desert the GOP. They may well take with them moderate Republicans who feel that the party should honor the outcome of the popular vote, even if they don’t agree with the majority’s choice of Trump. Once again, this scenario would probably end in a Clinton victory.

Republican delegates are left with an unenviable choice. Either course will, in all probability, split the party and result in Clinton presidency. 

Read it on Conservative Firing Line

Obamacare facts: Death panels and rationing

The phrase “death panel” is a politically charged term that originated with Sarah Palin in 2009. Palin coined the term in reference to the Affordable Care Act’s requirement that Medicare pay for end-of-life counseling sessions. Her original Facebook post on the subject read, “The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s ‘death panel’ so his bureaucrats can decide, based on a subjective judgment of their ‘level of productivity in society,’ whether they are worthy of health care.” Factcheck.org called “death panels” one of 2009’s “whopper[s] of the year.”

The ACA does not contain the phrase “death panel” and the end-of-life counseling cited by Palin was not mandatory. This does mean that Palin was totally off the mark however.

The ACA does establish an unelected board of bureaucrats who will be tasked with cutting Medicare spending. According to a description of the Independent Payments Advisory Board (IPAB) in the New England Journal of Medicine, the board will consist of 18 appointed members (including three from the Department of Health and Human Services) and will be required to submit proposals to reduce per capita Medicare spending in years in which spending is projected to exceed target rates.

The NEJM notes that the IPAB is prohibited from rationing care, increasing copayments, restricting benefits or modifying eligibility criteria. One of its few options is the ability to cut payments to doctors and, after 2020, specific providers such as hospitals and hospices. Overriding the IPAB’s recommended payment cuts would require a three-fifths vote of the senate. This means that stopping the IPAB’s cuts would be very difficult and most likely require a bipartisan effort.

The NEJM also points out that currently the IPAB’s recommendations for payment cuts for transactions through private health insurance are not binding. These price controls on private medical transactions would have to be approved by Congress, which, the NEJM says, “may not be able to cap Medicare expenditures without addressing private expenditures as well.” This points to price controls for private medical costs as a means of controlling Medicare’s runaway costs.

A consequence of price controls is fewer available doctors. If providers cannot charge a market price, the supply of providers will decrease. This is already happening in Medicaid. The Wall Street Journal reports that 31 percent of doctors already do not accept new Medicaid patients because the entitlement pays them at a lower rate than private health insurance companies.

Price controls are effectively a form of health care rationing. As price controls cause shortages, allotting the available care will fall increasingly fall upon government bureaucrats.

Rationing is the inevitable outcome of price controls and shortages. Donald Berwick, the administrator of the Centers for Medicare and Medicaid Services, said in an Associated Press interview, “The decision is not whether or not we will ration care. The decision is whether we will ration with our eyes open. And right now, we are doing it blindly.” President Obama appointed Berwick during a senate recess to avoid confirmation hearings.

Other countries with government administered health care have followed the price control and rationing model. Canada’s universal health care system has led to long wait times “for practically any procedure or diagnostic test or specialist consultation in the public system” according to the Wall Street Journal. In Canada, only half of ER patients are treated “in a timely manner by national and international standards.” Perhaps this is why the premier of the Canadian province of Newfoundland came to the United States in 2010 when he had to have heart surgery instead of going to a Canadian hospital. In fact, many emergency patients in border areas are sent to U.S. hospitals for treatment.

In England, the Daily Mail reported in 2008 that a government edict to treat patients within four hours of check-in had led hospitals to keep patients in ambulances for up to five hours before being allowed access to the emergency room. The four hour wait as measured by the government did not begin until the patients left the ambulance and entered the hospital. Over 45,000 patients waited more than one hour for access to the emergency room. Leaving patients in ambulances also means that the ambulances are not available for new calls.

In 2011, the Independent reported that budget cuts were forcing the British National Health Service to overtly ration health care. Two-thirds of the national health trusts in the U.K. are rationing treatments for “non-urgent” procedures. Examples of rationing include only allowing hip and knee replacements for patients in severe pain, delaying cataract surgery until the patient’s sight is substantially affected, requiring seven cases of tonsillitis within a year before allowing children to have a tonsillectomy, and mandating “exceptional circumstances” and six months of monitoring before inserting “grommets” in a child’s ears to improve hearing.

These economic laws hold true even in the United States. In Massachusetts, which has been cited as the prototype for Obamacare, the Boston Globe reported in November 2011 that tiered health plans with limited networks that force consumers to endure long wait times or pay more out-of-pocket to be treated sooner are becoming more common in the state. An analysis by the Cato Institute found that since Massachusetts enacted health care reform wait times have increased. Wait times for a doctor’s appointment in Boston, already longer than other metropolitan areas before the reform, have increased while they have improved in other cities. Health care costs in Massachusetts have increased faster than the national average and adverse selection, the sickest people choosing the best insurance plans, has led some insurers and employers to stop offering the most comprehensive plans.

Earlier this month, Massachusetts Governor Deval Patrick signed a health care price control bill into law. The New York Times reports that the new law will cap both public and private health care spending “so that it will grow no faster than the state economy.” The law sets up a commission to monitor increases in spending. The commission can demand an explanation from providers or insurers whose costs exceed the target rate. It can also fine organizations up to $500,000 if it finds that they did not make a good faith effort to reduce costs.

A 2009 Rasmussen poll indicated that only 32 percent believed that Massachusetts health care reform was a success. A more recent WBUR poll found that 78 percent still consider health care costs a significant problem for Massachusetts. Sixty-three percent say that costs have gotten worse over the past five years since the reform was enacted.

The discussion of quality adjusted life years brings the discussion of rationing full circle back to Palin’s original quote. Quality adjusted life years (QALYs) is a calculation that measures “the benefits gained from a variety of medical procedures in terms of quality and life and survival for the patient” according to Oxford University’s Bandolier Journal.

While the ACA currently forbids the use of QALYs “to determine coverage, reimbursement, or incentive programs,” an article in the New England Journal of Medicine is openly critical about the law’s prohibition, saying that the “notion that the country can avoid the difficult trade-offs that cost-utility analysis helps to illuminate” is “magical thinking.” If the law were amended to allow the use of QALYs, it might mean that older patients would be unable to receive certain surgeries because the procedure offered more benefit to younger people. It might also mean that babies like Trig Palin would be passed over for people in a more productive stage of life.

As the demand for health care increases due to more people being covered with health insurance, there are certain to be shortages since the supply of doctors and hospitals is not increasing. Rationing and shortages in such situations commonly take the form of long wait times for treatment and price controls. This has occurred in a multitude of other countries where government-controlled health care has been tried. Given the shoddy, backroom manner in which the ACA was written, it is unlikely to contain any new and different approaches that will work where previous government health care bureaucracies failed.

President Obama and the Democrats may have been able to pass the Affordable Care Act and get it past the Supreme Court. As yet, they have been unable to repeal the laws of economics.

Read the rest of this article on Examiner.com:

http://www.examiner.com/article/obamacare-facts-death-panels-and-rationing

Obama is right: Conservatives should be civil

Sarah Palin (Therealbs2002)

My friends and readers in Georgia and around the country will probably be shocked to hear me say, but I agree with President Obama.  A phrase that many native Georgians heard while they were growing up was “if you can’t say something nice, don’t say anything at all.”  This advice applies in politics as well.

Many Georgians have probably closely followed developments in the Tucson shooting, including the accusations that Jared Lee Loughner was inspired by conservative rhetoric.  These accusations were quickly discredited, but the controversy over heated political talk remains.

President Obama recently addressed these concerns in his recent memorial speech for the victims in Tucson.   He said, “But what we can't do is use this tragedy as one more occasion to turn on one another.  As we discuss these issues, let each of us do so with a good dose of humility.  Rather than pointing fingers or assigning blame, let us use this occasion to expand our moral imaginations, to listen to each other more carefully, to sharpen our instincts for empathy, and remind ourselves of all the ways our hopes and dreams are bound together.”

He continued, “If this tragedy prompts reflection and debate, as it should, let's make sure it's worthy of those we have lost.  Let's make sure it's not on the usual plane of politics and point scoring and pettiness that drifts away with the next news cycle.”

I think that he is right.  Even if political talk from the right (or left, after all, at least one victim, Judge John Roll, was a Republican) wasn’t the cause of the incident, we can still use it as an opportunity to slow down, take a deep breath, and think about alternatives to the way we are currently doing things.

Most conservatives are civil people.  There are exceptions.  There has been no shortage of conspiracy theorists on the right since the election of Barack Obama.  Most conservatives aren’t racists, but many have forwarded racist emails about the president.  Most Tea Partiers are nice people who love their country.  A few are nuts with insulting or bigoted signs.  Most conservatives speak in terms of facts.  A few want to label their opponents as “socialists” or “communists.” Most talk show hosts are reasonable and responsible.  Some, in the words of Neal Boortz, “make the kids run and hide under the bed.*” (Michael Savage, I’m looking in your direction.)  It is the exceptions that hurt conservatives everywhere.

Conservatives have nothing to fear from a civil discourse.  Facts and history are on our side.  Conservative policies work when tried.  Low tax rates lead to prosperity.  Second amendment freedoms lead to lower crime rates.  Economic freedom leads to a rising tide that lifts all boats.

On the other hand, liberal policies usually fail.  The Obama stimulus was a massive and expensive failure that did not lower unemployment or end the recession.  The same was true of FDR’s New Deal.  Gun control disarms honest people and leaves them at the mercy of criminals.  As President Reagan said, “… some years ago the federal government declared war on poverty – and poverty won.”  Liberal engagement of despotic regimes has led to nowhere except the empowerment of dictators.

The path to conservative victory is through showing the rest of America the differences in liberal and conservative policies.  In particular, we should point out how, despite their good intentions, liberal policies are prone to failure and unintended consequences.  Good intentions don’t matter if the result is a bigger mess and more problems. 

Some conservatives point out that liberals are the ones doing the majority of the name-calling.  From my perspective this is probably true.  That doesn’t mean that conservatives should respond in kind.  First, we should expect the left to be angry precisely because of the failure of their policies.  They cannot argue the effectiveness of their policies, because their policies are ineffective. 

Second, it has been my experience that liberals are usually emotional, rather than logical, people.  Their emotions dictate a call to action to resolve a crisis.  The rallying cry of Maude Flanders on the Simpsons is typical of modern leftists:  “Won’t somebody please think of the children?” All too often, they take rapid action, and then fail to notice, as they are congratulating themselves on their compassion, that they made the problem worse.

Health care reform is good illustration.  For years we were told that the US had to enact universal health care since many Americans were dying because they could not afford health insurance.  Then last year, against strong public opposition, Democrats enacted their version of health care reform.  This included many provisions such as free preventive care, a ban on excluding pre-existing conditions, and the claim that a new entitlement would help reduce the federal deficit and lower everyone’s health insurance costs.

Less than a year later, while Democrats are still congratulating themselves on their historic legislation, the truth is still coming out.  By not letting insurers screen out pre-existing conditions in children (this provision is not in effect for adults yet), the law has caused the market for children’s health insurance policies to collapse.  Many companies are no longer writing child-only health policies and others have been forced to raise rates, making the coverage unaffordable.

Far from making health insurance more affordable, the health care reform law has caused health insurance premiums to rise.  A report by Medicare’s Office of the Actuary projected that the law would increase health care costs.  The report was released not released until after Congress had passed the law.  Millions of Americans, me included, are finding that under Obamacare their health insurance costs are going up.  The much vaunted high-risk pools to cover those with pre-existing conditions have signed up only about 2.6% of the number predicted.  By all measures, the law is a spectacular failure.

The American people understand all this.  They consistently opposed passage of the law and now they consistently favor repeal.  In spite of Democratic and media support for the law, most Americans understand that it will add to the federal deficit, cause a decline in the quality of US health care, while hurting the economy and job growth.  If conservatives start engaging in a heated war of words with liberals, these facts may be obscured.  In fact, that is what the liberals are counting on!

Brooks vs. Sumner (John Magee)

As other conservatives have pointed out, today’s political arguments are not as heated as they have been at times in the past.  Sarah Palin was criticized for pointing out, correctly, that the Founding Fathers sometimes settled disagreements with dueling pistols.  Even duels paled in comparison to May 22, 1856 when Rep. Preston Brooks (D-SC) severely beat Senator Charles Sumner (D-MA) unconscious with a cane on the floor of the US Senate.  Brooks was re-elected.  Sumner later became a Republican.  Things got worse only five years later with the outbreak of the War Between the States.  Nobody today wants a war or violence.

In contrast, the Republicans should take a lesson from the liberals and the Bible.  Proverbs 15:1 says that “A soft answer turns away wrath, but a harsh word stirs up anger.”  This can be seen in the eight years of the Bush presidency.  Liberals were daily excoriating President Bush with accusations that he lied to start to wars, was complicit in the 9/11 attacks, caused global warming, allowed New Orleans to flood because he did not care about black people, and much more.  Where did it get them?  President Bush served two terms and was a largely successful president.  Voters rallied to support the president from unfounded attacks.

If conservatives mount baseless attacks on President Obama, we may suffer the fate of a second Obama Administration.  A new poll shows that 48% of Americans disapprove of President Obama’s policies, but only 21% disapprove of him personally.  Will conservatives win votes by insulting a man liked by 73% of the country?  It would be a far better strategy to attack Democratic policies rather than the president.

Finally, it has been pointed out that liberals are unlikely to maintain their air of civility very long.  This is true.  When you can’t defend your record of accomplishments, the only thing to do is either change your mind or lash out with charges of racism, sexism, or the accusation du jour.  Already one House Democrat has again started comparing Republicans to Nazis.  More will probably soon follow suit as the Obamacare repeal effort gains steam and the debate over debt financing heats up.

To this I say that Republicans and conservatives are not responsible for the behavior of Democrats.  We are responsible for our own behavior.  If the other side wants to (or has to) resort to childish name-calling to distract from the lack of positive results of the policies, then let them.  The conservative response should be to politely rebut their falsehoods and maintain civil criticisms of their policies.  This worked in the last election.  It will work in the next.

http://www.examiner.com/conservative-in-atlanta/obama-is-right-conservatives-should-be-civil#ixzz1BbvhBjU3"> 

*Boortz is quoted as recalled by the author during an on-air live promo for the Michael Savage Show on WSB-AM 750.