Thursday, January 18, 2018

Big Bang Theory of Health Care: Ever Since 1967

Hold on to your hat: it all comes together now. Looking at events in our nation's capital, in a strange fever dream, The Big Bang Theory just came to me. No, call it the Big Fecal-Bang Theory, as I read about how our national leadership proceeds from one inanity to the next.

But when it comes to health care, and wiping out the safety net using false premises, inanity kills. So this is worth writing. But to see how it all ties together, we have to go back over half a century.

Where else can you read about the hidden connections between Hollywood, health insurance in the US of A, Really Bad Tax Cuts, Wisconsin cheese-eaters, opiate addiction and Really Bad Logic?

We will conclude with the antics over the past year of Senator Ron Johnson of Wisconsin in the annals of health care. But to pull it together we have to back to just over fifty years ago. Take a walk back to 1967.

That year two events occurred involving two major characters of the day. Hollywood!

The first was the ascent of an actor named Ronald Reagan, perhaps our first media-celebrity politician, to his first term as California governor. Some time later, eyeing higher office, he was insisting government-is-the-problem-not-the-solution. A mantra carried through ever-bigger megaphones until we arrived at the present day s-house.

California, of course, as a whole is now far less likely to throw up right wing politicians onto the national stage. (Rep. Issa is leaving it as we speak.) But our great expanse of red fly-over country still belches forth people like Paul Ryan and Ron Johnson to bollix up health care and pretty much everything else.

The second event worth recalling from 1967 is the grand Oscar-winning Mike Nichols and Buck Henry collaboration, The Graduate.  Forget about the stars. They're still in the news for all sorts of peculiar things. Remember Mr. McGuire? Until our current president trumped him with a potty-mouthed single-word viral epithet, Mr. McGuire was the single-word champ, with his fatherly diatribe to Dustin Hoffman on the future: plastics.

(The actor, Walter Brooke, who was among other things a big Thomas Jefferson enthusiast, was reportedly so enthused by his role that he remained forever wistful about his own failure to invest in plastics. Starting in 1968, though, many more did take the fictitious Mr. McGuire's advice, earning tidy sums in life imitating art.)

Show biz carrying over into the public square: Nothing New.

A decade or so later and now far from Hollywood, another family, that of today's Senator Ron Johnson saw the same writing on the wall. They launched a company in Wisconsin now called Pacur. A bit off-subject to explore just how much credit this intrepid midwestern businessman-turned-politician can take for single-handedly pumping up a company that specialized in plastic extrusions.

But by 2016-2017, Johnson had done just that in spades. And now according to multiple sources he allegedly uses the recent tax-cut legislation to win all sorts of special concessions for plastics from the GOP leadership in exchange for pushing that legislation forward. (See the cheesemen's connection with each other and the alt-right here and here.)

Simultaneously in 2016-2017, according to the reliably right wing organ Washington Examiner, Johnson was already now making a prefatory argument about Medicaid and how it might be responsible for the opiate crisis. That this took my breath away is what, in the event you're still reading, prompted the screed I'm now writing.

So first the boys from Wisconsin enact a bodacious and totally not needed nay harmful tax cut, favoring the wealthy. But long before its success was assured the cheese boys were preparing the ground for the dismantling of Medicaid. First you create a deficit by handing out tax breaks to rich friends. And donors. Then you produce the "evidence" for where the resulting deficit can be addressed, on the backs of poor patients.

That this evidence is specious is almost beside the point. It appeals to the Base, if that's still big enough (it is until November 2018 proves it isn't) to make a difference in pushing through the proverbial Drowning-of-the-Baby-in-the-Bathtub.

But the striking logic used by Johnson allows us to conclude with observations on the multiple fallacies of reasoning commonly committed by the increasingly extreme proponents of this grand new idea of repealing the twentieth century. Brings us right down to today--January 17, 2018--and the hearings Ron Johnson held on the vestiges of the Affordable Care Act and Medicaid expansion. Allegedly they were "trying to link Medicaid expansion to the opioid abuse epidemic."

The notion--now soundly disproved, if such things matter, by actual evidence--that decent health insurance gave more people access to prescription drugs, including opiates, and was therefore harmful as an unintended consequence, is as laughable as is climate change denial. But why should that stop them when "it's just common sense"? (I paraphrase.) The new line of attack on Medicaid is like so much other demagogic off-the-skids reasoning coming to us from extremists of every ilk.

They suffer from so many logical fallacies it's hard to know where to start. (But a good place is here, at UT El Paso.) The argument-from-pathos: "trust your gut." Too, the related biases of Confirmation and Availability, allowing for these wingers' selective use of "evidence" that only seems to bolster their view: "more people with addiction have Medicaid that those who don't."

Say what? See also: the Big Lie Technique. Over-generalization. The Post Hoc Propter Hoc Fallacy, famous ever since the Hippocratic writings. This last one is key: "Disco caused AIDS."

Or, more to the point, as a thought experiment, imagine what could be next when your parents and grandparents stand to lose some or all of their Medicare coverage. Analogous to what the boys of the GOP are doing with Medicaid--a cheap shot and easier target than Medicare.

"Evidence is now showing that addiction to death is far more common among people who have Medicare. Death is bad. Let's gut Medicare." The people don't count. What counts? Plastics!

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