A few months ago I wrote about the impossible task that Trump had set himself getting rid of Obamacare:
Trump’s basic problem is that the US has been drifting closer and closer to a socialised healthcare system for decades as Federal and State spending on healthcare has over-taken insurers and private individuals. All Obama did was codify a socialised system that he had inherited from W.
Trump’s options were always limited:
- Replace Obamacare with another socialised healthcare system
- Roll back healthcare provision by a couple of decades to reduce state and federal spending
- Bluster loudly and tweet stuff
Plan 1 was politically impossible within the Republican Party, Plan 2 would have involved taking healthcare away from lots of old, poor and chronically ill people (who are Trump’s base), and so we ended up with lots of bluster and tweeting.
In response to Coronavirus Trump has increased the proportion of healthcare spending that comes from Federal and State expenditure to levels undreamt of by Obama or even Bernie Sanders. Levels familiar to Western European socialised healthcare systems. Trump has taken the USA closer to European socialised medicine than any Democrat ever dreamed.
Despite spending more on healthcare than any other country the USA has the highest number of deaths anywhere in the world, and when the final excess mortality is calculated the actual numbers will be well over 150,000.
It could actually have been much worse – the US has lots of rural and semi-rural communities with poor health, high levels of obesity and diabetes, high death rates, and poor access to healthcare. If Coronavirus takes hold in those communities the death toll will be very much higher, even double.
It hasn’t yet taken hold in these communities for the obvious reason that they are already socially isolated. No-one goes there, and no-one from there goes anywhere else. Coronavirus has revealed the extreme isolation of lots of Americans.
The most likely outcome of the next presidential election is a Democrat President, although not necessarily Biden. Trump became President while losing the popular vote by the biggest margin in US history admit Russian manipulation. The last Republican to enter the White House with a majority of the popular vote was George Bush Sr in 1988. Against the back ground of economic collapse and stumbling response to the virus his chances of re-election are very slim.
An incoming Democrat will inherit a socialised healthcare funding system, with the state controlling as great a proportion of healthcare spend as in the welfare state economies of Western Europe.
They will also inherit a private hospital sector on the brink of total collapse. US private healthcare loses money on ER and emergency services, but makes a massive profit on elective care. The pandemic has flooded the system with emergencies and driven away elective patients. Without urgent Government intervention lots of US hospitals aren’t financially viable, some may not make it until November.
The Democrats have same policy options that Trump has but without the ideological fixation against government involvement in healthcare.
The Democrats are heading towards a radical new model of Government funded healthcare, well beyond the imagination of most activists. Not because Biden, or whoever gets the nomination is a radical leftie, but because those are the cards they have been dealt. There are few if any other options left open to them.
I am sure that Trump won’t go quietly given that he is likely to face jail time and/or bankruptcy. And I am equally sure that some of this supporters will try and stop an incoming Democrat administration, some with guns.
Ulimately I dont think this will come to very much for the obvious reason that gangs of fat angry bald men in army fancy dress are no match for an actual army no matter how big their guns are: