OH. MY. GAWD. He’s so wonky and neat! And so smart! Other politicians don’t get into the policy and really understand it the way Paul–I’m allowed to call him Paul, he told me one night while I was staring into his eyes on TV–does. What brilliant thing did he say today?
Well, he’s not wrong–healthy people subsidizing sick people is the “whole idea of Obamacare.” In fact, it’s the whole idea of health insurance. Policy genius Paul Ryan doesn’t know how insurance works. Paul’s solution to this problem, amazingly, isn’t to get rid of health insurance and adopt true universal healthcare like every other industrialized nation on the fucking planet. His solution, now with three times the wonkiness, is apparently that the government will “subsidize” health care for sick people so that the insurance market can strictly deal with healthy ones. That’s…not how insurance works, and there is no way in hell that his plan will actually appropriate enough money to pay for the health care of anybody with a pre-existing condition.
What Ryan is doing is, in some dialects of English other than Media English, called “lying,” which is this thing where somebody says something they know not to be true in order to convey a falsehood to his or her audience. As long as we insist on maintaining the supremely fucked up private for profit health insurance business, the only way that insurance companies can afford to take on sick people is if they also take on a bunch of healthy people who probably don’t want to buy insurance. This leads to all the shittiest parts of the ACA–the mandate, the garbage high deductible policies, etc. But if you want to get rid of those shitty parts, you have two choices: enact genuine health care reform, like single-payer, or tell people with pre-existing conditions to go fuck themselves. Republicans won’t do the former, obviously–hell, Democrats don’t even want to do the former–and they can’t do the latter because Politics.
So instead, Ryan has to play this game where he pretends to care about people with pre-existing conditions with his pretend fix that can’t work, knowing full well that when the rubber hits the road, he and the rest of his party would gladly stick every sick person in America on an ice floe in the Arctic Sea if it meant they could finance another massive tax cut for Paul Singer et al. But they have to bullshit the public for now, and despite the fact that they’ve collectively fallen for the same completely made-up “Paul Ryan: The Wonk Who Cares” myth over and over and over again for the better part of two decades, our media still hasn’t learned that Paul Ryan isn’t a wonk and doesn’t actually care.
The Foreign Exchanges Companion 