Wednesday, August 3, 2016

Pathological Politics
The pathological national politics now  being practiced disturb me.  By “pathological “,  I mean extreme in a way that is not normal and that shows a disease or mental problem,  usually obsessive compulsive behavior. 
There’s something sick, uncivil,  pathological about what’s going on.
In the case of President Obama,  his decision to declare Donald Trump  “unfit” for the presidency  during a press conference for the leader of Singapore,  is pathological politics.   A lame duck president generally stays out of the politics of who is going to be his successor.  Not Obama.  He refuses to play the role of a lame duck.   To protect his legacy,   Obama is obsessed with declaring Trump  unstable, unpredictable,  and uninformed about the duties of a President,  why Trump  is not qualified to be President,   and what it takes to be President, which it seems, it someone who believes  in man-made  global climate change,  ObamaCare implementation,  withdrawal of the U.S. as a global economic leader, and leading from behind.
 Donald Trump is preoccupied with reacting to every criticism, no matter how trivial,  by “hitting back,”  calling Obama the “worst president ever,”  giving a litany of bad economic statistics under the Obama-Clinton team,   and calling Hillary Clinton a “pathological liar, ”   “weak,”  and lacking “energy” to do what needs to be done.    He looks upon every presidential action as a “business transaction,” or “the art of the deal”, “whether it involves defeating terrorism,   dealing with Putin, funding NATO,  or delicate diplomatic  negotiations.   Trump would be wise to focus on negative Obama economic results,  not  presidential insults.
Health Law
With the health law,   the pathology involved  concerns the power of big government and its ideas for controlling the system,   e.g.  by consolidating small practices into big practices,  herding doctors into integrated systems,   or  into  accountable care organizations, where doctors and hospitals  are rewarded or punished by  success or failure in meeting Medicare budgets for populations of patients.    If systems or ACOs are not up to snuff,  in Obama’s mind,  it is the fault of the providers,  not the omnipotent  government or its unworkable  policies.  
 Health Exchanges
Then there is the pathology of the health exchanges.   It is now glaringly apparent,   the big major for-profit  insurers -  UnitedHealth,  Humana,   Anthem, and  Cigna – cannot stay in the exchanges,  satisfy their investors, and remain profitable.    The big plans have all suffered multibillion dollar losses  because of the shortfall of the young and healthy to join the exchanges,  and the surplus of older and sicker people to sign up to take advantage of government subsidies, and then to drop out once they have been treated.   A big part of the pathology here is that insurers cannot identify in advance what persons, i.e. those with pre-existing conditions,  are likely to produce losses.   When insurers cannot predict the hazard, chance, or probability of a loss,  they are choosing not to remain  in business to please the government while losing their shirts. The insurers are not about to give government the shirt off their backs.  It is not an equitable exchange when  one side gains and the other side loses.

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