Re: New Health Care Bill . . . many on the Hill are unhappy for many different reasons. There are a lot of divisions w/in the GOP. HHS Sec’y Tom Price wants individuals to have ‘choices’ they don’t/didn’t have under the ACA. Price thinks ‘more’ people will be covered under the new plan and that competition will drive the costs down. Former HHS Sebelius says anywhere from 2 – 15 million ‘will’ lose coverage under the new plan.
- Politics makes it impossible to fix (the ACA)
- There’s a huge tax cut for the rich ($250K)
- The GOP ‘is’ the “Party of the rich.”
- DT and the GOP are not trying to do a *real* ‘fix,’ they’re trying to fulfill a promise
- Why no CBO scoring? “They’re already discrediting the CBO — before they release their report!”
- Capitalism isn’t working for everyone
- Dealing with life and death issues here
- It’s going to take everyone coming together — and that’s not going to happen
Paraphrasing John Kasich (R-OH):
- The ACA is not sustainable . . . but,
- We shouldn’t throw the baby out with the bathwater
- There’s no provision for consistent coverage for those in need
- DT ‘is’ open to compromise
- Need more of a ‘market driven‘ system
- We need to pay for quality, not just quantity
- The political parties are disintegrating before our eyes; many people hate politics because of all the squabbling
- Losers have a “What’s in it for me?” mentality
- Dems are “top down” people . . . need “bottom up” people (GOP)
The top-down implementation approach is a clear-cut system of command and control—from the government to the project, which concerns the people. The top-down system showcases: (1) clear and consistent goals—articulated at the top of the hierarchical environment, (2) knowledge of pertinent cause and effects, (3) clear hierarchy of authority, (4) rules established at the top and policy is aligned with the rules, (5) resources / capacity to carry our the commands from the top (Elder, 2011, lecture). The top-down approach is the rational comprehensive approach to planning. It is consistent with overhead democracy, whereas elected officials delegate implementation authority to non-elected public servants (civil service) who are accountable to the democratically elected officials. However, DeLeon and Deleon (2001) point out that top-downers may implement [EPA] policy with standards that citizens do not understand, which might also circumvent their rational preferences. When this happens, top-down becomes a “tactic” and not a strategy for implementation.
Bottom-up designers begin their implementation strategy formation with the target groups and service deliverers, because they find that the target groups are the actual implementors of policy (Matland, 1995, 146). Moreover, bottom-uppers contend that if local bureaucrats [implementors] are not allowed discretion in the implementation process with respect to local conditions, then the policy will “likely fail” (Matland, 1995, 148). Accordingly, goals, strategies, and activities must be deployed with special attention to the people the policy will directly impact. Thus, evaluation based upon the street-level bureaucrat would be the best practice (Matland, 1995, 149). For example, Matland discussed Hjern’s findings that central initiatives poorly adapted to local conditions failed, and, that success depended greatly on the local implementer’s ability to adapt to local conditions.
DeLeon and DeLeon (2001) find that bottom-uppers are more likely to be reflective of community interests, while top-downers are more likely to impose policy narrowly upon focused interest groups (478). They conclude that bottom-up implementation is “more realistic and practical” and much more “democratic” than the top-down approach (Ibid). Further, if the policy is indeed meant to coerce people’s behavior, then the bottom-up approach may go beyond informing people of the proposed legislative action to manipulate behavior. In fact, bottom-uppers may garner the consent of the target group before their representatives’ vote for the law.
Some examples of what it would look like under the new Health Plan for a 60-year old making $40,000 a year:
In Clark County, NV ACA: $4380 GOP PLAN: $4,000
In Northumberland County, PA ACA: $11,150 GOP PLAN: $4,000
Under the new plan –> subsidies would decline 81% in counties Clinton won and would decline 93% in counties Trump won.
Under the new plan Trump voters are hurt more than Clinton voters.
US EMPLOYMENT INCREASES
235,000 in 2017
237,000 in 2016
238,000 in 2015
- When Trump says things are corrupt and rigged it creates a form of intellectual pollution
- DT calls everything the “opposition” that disagree with him
- DT’s talk about the “Deep State” is very destructive.
It isn’t the “Deep State” that is making President Donald Trump look like an amateur. It is amateurism. It is not the “Deep State” that prevents, say, serious reform of the financial-services industry. If you want to understand why Wall Street reform seems so difficult, you should begin by considering the fact that Wall Street’s most energetic critics do not understand what Wall Street does and have no interest in taking the time to learn. The most concrete banking-reform measure Bernie Sanders ever proposed before the financial crisis was a cap on ATM fees. You don’t need a “Deep State” to outmaneuver enemies like that. Bernie Sanders couldn’t outmaneuver Mr. Magoo. Watching Barack Obama careering around Syria policy was enough to make one wish there were some highly capable men in black behind the scenes pushing him in the right direction — they could hardly have done worse. Neocons, globalists, the Deep State, the shadow government, the International Jew, the Illuminati — it is nice to have someone to blame, especially if that someone does not exactly exist. (Any errors in this column are the fault of my intern, Skippy.) This is sloppy and stupid, and it is counterproductive, too. Team Trump’s first-down fumble on immigration and congressional Republicans’ apparent surrender on the Affordable Care Act are not the result of arcane and shadowy forces acting against the American interest — they are the result of choices made by identifiable people, and those people have got to go. But that is not going to get done if you spend your days hunting the political equivalent of the Loch Ness Monster. President Trump likes to read the tabloids, but presumably it was not Bat Boy advising him on that first executive order on refugees. The irony is that all this chasing after shadows instead of undertaking the hard and thankless business of governing is one of the things that empower those unaccountable bureaucrats and the time-servers in the alphabet-soup agencies. You think they’re sitting around having debates about how many neocons can dance on the head of a pin? There is an ancient superstition that to name something is to assert power over it. (The members of some ancient tribes kept their real names secret and had secondary names for public use.) But giving the figments of your imagination a name and an involved back-story doesn’t make them real. It just makes you nuts. — Kevin D. Williamson is National Review’s roving correspondent.