« The Weeds

The worst GOP healthcare bill yet

2017-09-20

Ezra and Sarah parse through Graham-Cassidy, the latest Republican repeal bill. White paper: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3025749

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This is an unofficial transcript meant for reference. Accuracy is not guaranteed.
I'm perfect then have no problems. I have some for huh Lowell, Bergman, weeds boxes, policy broadcast on the box, media podcast, Porthos Network I've just I am as reclined not magically see as he is in one German, IRAN somewhere he's he's in Germany for the terminal actions. Yeah he's been posting figs on its grim is, I think, a joint his sojourn away from american painting. Are we, its fans and improved but I am joined by circling answer. I, Sir Hey has gone crate and we have a very big weeds episode. Today we have a new paper by casts: Einstein called unleashed. That is pretty interesting,
I think, on rhetorical dynamics of how social movements begin and pretty applicable, to the Donald Trump Presidency, but first finally after a couple years of doing the show. It's time we did. episode on Healthcare. And in particular on the ground, Cassidy fill the gap Cassidy Johnson, about how I'm not I'm not going to do this. I'm interested in how Heller's on this bill that his governor Brion said of all has asked to not have brought up in the Senate at all, but before we added to that we're here to talk about the process, which is much we order on this bill than it has been on any of the other bills like this is a if you thought previous. he'll p health care about processes we're fucked up. Until you hear how this without getting co, but policy is much more radical and ambitious and sweeping your you, I think called it. The most rapid of all the Gb Healthcare bells. Sarah eyes, a true yes, I've
I have spent a lot of this year, reading Republic and healthcare plans and they generally look race learn that a lot of people whose coverage premiums go go down, for some people go up pretty significantly for sick people, but good Cassidy is really in a category of its own. In my view, and the reason for that is the other reports. in plans is actually make a poorly funded version of the affordable care act. They ratchet down what states get to run a medical, Span Jane. They pull back the tax credits for people, who are middle income and by the market places, but those things will exist in some sort of form. There still is a market place where there are subsidies. There still is the opportunity to you, medicate expansion, you're, just gonna, get a lot less money from the federal government green. Cassidy is not a poorly funded version of Obamacare, essentially blows up the affordable care act It takes all the money that is being spent right now on medicated turn on the market places it bundles that up a cuts.
two hundred two hundred fifteen to to thirty nine billion off the top over the net ok, then ask a question about, because because I think this is a really important piece of it, that I do not understand is why you do so what bananas are taking the Obamacare money, putting it into a lump sum, and basically attaching to growth rate. That is slower. Yes, is how to cut works again, because there is the growth rate is slower right, there's nothing in Graham Cassie. That's as we take the money and we cut it by expert hands, but by time you get a twenty twenty six works out to a seventy percent cut and its because, like you said Esther funding formulas, just work quite differently in Sicily, there are no more marketplaces underground capacity. There is no more medicate expansion. Those are things that the federal government is not involved with, does not find tat all disappears that infrastructure in The money is divided up in a really way. So what is it?
Senator Cassidy who I spent some time in his office on Friday. He will point out that the funding Health care is very uneven right now across the country, a state like California is getting so much money, whereas a state like like Burma, for example, is getting less money. The reason for this despair It is quite obvious, obvious. California, expanded medicate, Alabama didn't, but he looks at this problem. Many says: look. I've had seven years dissipated, Medikit expansion. They decide not to. This is an intractable problem and what we to do is take all the money that exists and rediscover. put it in a more equal way. California should not get to keep all its medicate expansion money. It needs to send some of that too Alabama. So you have this. Being formula that essentially takes from states that have been very good, implementing Obama care? And I want to point out that I think there is this narrative that has developed that it's basically redirecting money from liberal straits, too conservative states that is true to extend. It also hurts a lot of more conservative states.
instant, for instance, senator. Has it he's home state of Louisiana which recently expanded, medicate and I've got to say I was in Cassidy's office He spent all this time. Talking about how great medicate expansion is worked in Louisiana, they signed a foreigner and fifty thousand people it's been faster than ever spected and then very abruptly transition to the fact. But it's not fair over you know stalled onto that money. We need to share it with the rest of the country, and so you see, Sir, like Louisiana, losing out Kentucky losing out Nevada, where Heller's from losing out into this year, because I think this is a really important thing to understand about the spill. Every one of these reports and plans, has in some way been fatally hampered because they- system, using reconciliation and not just creating health care policy and try to get the democratic votes for or whatever it might be and so you you might ask a glistening too, to usurp. Well, why not, make the funding sort of
ideally, of alma care funding? Why not say this is going to you know? Its funding is gonna. Just by need would be one way to do it. You could also to say its funding that matches, while we think the funding would be if everybody expanded meant. it right in and that's hey equalizer tend to then you know it's not. Instead, like bring California down, you bring Alabama up. And the answer I mean they're pry lot of answers. Ideological answers, public I want to spend more money on healthcare, blah blah blah blah, but one, answer. Is it under reconciliation? They cannot spend money like that. They they they are hampered by sort of what they have already put into the reconciliation instructions, and they can't expose the federal deficit and interest in general spending money is quite a bit harder. They obviously are not going to be able to impose new taxes to raise anything so so they're they're really am strong, and so their hamstring into this really really messed up funding formula that makes states like Ohio a huge loser on John Kasich said: please don't bring this bill
four Nevada is a so Sandoval so pleased humping. This bell to the floor. Alaska is a huge loser and by the way I mean maybe Nunneley senators care, but that's Rob Portman and Dean Heller and listen Rakowski, and I just keep going back to this because they There is a version of this balance, and we can talk about this- that I actually imagined could have gotten some bipartisan support, or at least would have been a plausible candidate for it, but they would have had to good, not do reconciliation and they would have had to say we're going to try to create a health care bill that try to create like on Obamacare, pure replace, who can jammed through by September? Thirty four fifty one votes, no matter what happens like actually stop and try to create some health care policy and that to me it is the question I cannot answer That is why they just never try that, like whitish is never the plan that we're gonna the bill where
think it can went into hook, public support. We think it's a good bill. We think it's such a good bill that we're gonna wait for congressional Budget Office scores and defend those course to the country. Like white is always this total keystone cops slipshod process. It doesn't be keep suggesting this lake It is some external force making them do this and it is not. It is a damn. I think there is actually a version of this thou. So I kind of I consider Cassidy Collins dealing early early early February version of this, which is I want in southern versions of the same bell. They just happen at the same senators name on them, but that was a bill centrally, and you know something I hear Senator Cassidy's say allied this. Enter. Was you know it if California Obama CARE, that's fine. They should keep running Obamacare Button Louisiana wheedle like Obamacare, and we want to do something different. We but take our money and change it and I think that's kind of what ends I know some
some level. Our liberal analyzed looked at that bill. It does include a slight budget cut for California, but just ideologically like that is something that I think is peeling an interesting. I think it is certainly true that the affordable, correct has not been as robust in certain places as them. As its drafters would have liked, and I think if Louisiana, as some other plan and wants to try. You know what I don't feel like. I've strong objections to that, but this is not that plan this is a plan where California, Ohio Kentucky, cannot run the programmes they currently run. They cannot continue Keeping Obamacare and the work, so even if you, even if they do like it, if they feel it it's working well for their state and the incentives here are so perverse one of the states interesting for me to look at is Florida. Stated and did not expand Medicaid, but actually loses a lot of money through gram. A city and the reason that it dies is because floor
has been really excellent. Signing people for coverage day some surprisingly, have the largest market place in the country, they get a million dollars in tax credits than any other state in the country and Just then a really really good job on outreach, which means a lot of money coming into the state. Cassidy Graham looks it. state like that and says: oh no, you don't deserve all that money. Utumbi Alabama needs that money in Georgia needs that money it is really really eyed and studying to me that people who have decided to make an express decision not to spanned coverage, always unrewarded with this windfall of money So many thousands by want to ask you about a couple other pieces of this, because I think that it is important to make sure we put into the into the beginning of a show here. So ok, so first ten year is basically in twenty twenty capacity. ram. Dissolves Obamacare by twenty twenty six, seventy percent cut what happens in twenty twenty six
Luck Grant disappears Ezra, because for some reason that has not been explained super while by any the drafters of this bill, it is funded as a temporary rather than permanent programme Cassidy's. His office is argued that their concern by budget rules that they can't fund past like this cry better like, but confuse shrug EU that, as there is giving me across the table this? The reason I'm so confused by this is that you do see this happen. The Bush tax gets expired after ten years, but the reason is under reconciliation. You cannot increase the budget deficit outside of the ten year window. The way stand, Grand Cassidy there is no way in increases the budget deficit out of the ten year window. I saw this trick. You do of make They expire unlike midnight. Ten years from today, I dont understand whether using it nor do. I have not got a good explanation of this again. They always come back to these budget rules which I agree, do not actually constrain them in some way. If you look at the so there's too when are we haven't talked about? Is there's the marketplace in the medical
mention gang, bundled up turned into a block, grant, there's also met he had getting overhauled. So all these per capita caps that showed up in the old Senate Bell and the House bill. Those are going on and those continue as a permanent programme. So it's very confusing to me that the medical funding that continues permanently, for some reason: the block grants drop off in twenty twenty seven So we will make the argument that I am a few Congress, of course, they're going to step in and provide the funding. But someone tenuous ended. you know you ve got a lot of republican governors raising this concern. We do want to take the medikit expansion because we're not sure if the governments going to fund at ivy sounds like a pretty strong signal were really not really sure if we're going to find it. So there's also this question of you know: let's You know stick with Alabama: they got all this money. I have We heard Alabama clamouring for extra money to implement healthcare programmes. I dont know if they want, given this funding cliff like what they would do with that? This.
I don't know it doesn't make allotted zoom out there so use what are they weaken he Curtis summarizes to you, and you tell me if the sounds right first, ten years Cassidy, Collins, sorry, first, ten years, Cassidy Ground Grandpa S, it is actually a hostile. Graham chastity takes the healthcare system. We have. Dissolve Dixie Obamacare men get expansion system, dissolves out money into single funding stream, redistributive funding stream. In a way that means it states that are currently the states robotics performing well because they ve taken the medicate expansion and pushed hardest people up, they do not have enough money to keep running the current programme, yet they have to do something with a lot less other states it if you're not much interest in doing a lot to help our policy there given money with very few strings attached to do so. Thing where they don't really have to have any goals at all? So that's for ten years The aim of that ten years, everything this here is potentially but may be Congress.
authorizes it did, or maybe they add new springs, and we have no idea what that Congress will look like or what that constellation of political forces would look like going forward after that simultaneously there, these deep, deep, deep, medicate cuts it keep getting deeper going into that second decade, so medicate ends up pretty gutted, so that's I'm Cassidy? That's the way of working time and again. This is this is different from the other Republican, like way more. This idea of block reads: call the block and when you sign of a gives states just a lump sum of money, this idea of block granting the medicate expansion the market places it doesn't show up in any of the other plans, and it really gives states alike of leeway about what to do with that funding. It was it is clear. It is exceptionally good. And affordable care act. That money has to go to help get people, health, insurance, There were some strings that existed in the other republican plans. It had to give help people health insurance, but maybe it wasn't low income people. Maybe it was wealthier people, but again the money was committed to health insurance under grim.
Osity. There's Canada's laundry list of things you can spend it on Ebay, could give all that money, tier state hospitals and say use this to prove to pay for uncompensated cares. You could create a high risk. Poland say that's how we're going to use this money. There is no mandate and Graham Cassidy that the block grand has to be put towards giving people coverage. Has we put some health related purpose, but that's quite brought and there isn't much too tethered to low income people, which is something they see it as quite clearly which makes us slush fund so I think that you might expect states to do because we see this happen, as happened with welfare or form, so some states that do not really want to be increasing coverage. In and by the way, it's a lot of work for a state to be told by twenty twenty yards. filled the whole who helped us to buy me. A lot of sweets didn't even bother to set up an x by even states liked Obama varieties are to say: ok, hospitals, here's this money, we got use it
yo you. There are a lot of way. I'm in states do currently spend a fair amount of money and healthcare. There a lot of ways to pump the money they are now getting from the federal government into things that are, let's say, existing a needs of your state and then take money, they estate was spending on those needs and move around, and The federal government can try to do certain things and it has little provisions that they can trust that from happening, but the very an affair I mean the way you would normally do something like this is you would set standards? He would say: ok in order to qualify for the money, you have to come back to us and present a plan that has to be certified by H, H s as it's going to cover say ninety percent of your residents with coverage or it's gonna, have you no asthma? coverage is a bomb care, but at lower cost him in their ways. You can do this, you set things up and then the plans have to be. faster against that set of goals grown ass. He does not have goals like now it beer. It has one very vague, also think it doesn't hurt what you're talking about, but there is a line that says that people pre exist
Conditions have to have adequate access to help to healthcare. None of that. To find those. So a lot of that you don't have talked to of experts who say could use and about high risk cool and that counts is adequate. Like baby could you just give your hospitals among my paper and compensated uncompensated care in this actually kind of get one of the area of the bell, but it everyone discuss, which is what happens to pre existing conditions. What happens to the individual mark That's because I think, there's a lot going on there that even for people who don't receive these tax credits would stand to see big changes. So then this is relatively Where do some of the other bells? There is a waiver in gram capacity that lets states bring back preexisting conditions, ditch the essential health benefits, meaning they d have to government maternity cared enough to cover, prescribe drugs under grim Cassidy, if you applied for one of these waiver is- and it was accepted, then you could charge people more because they are sick because they are prey
and because of anything except for age or membership in a protected class under the this constitution, other than those are the only things you are barred from charging higher prices on. You could take out maternity Are you could take out mental? How you could take out a lot of benefits and all of this would happen and twenty twenty or looking at two years from now, when the digital market in Reno, we're talking about people who aren't getting these subsidies. People who are just buying their own health insurance right now from being a blue cross in their state that you would see very much of a return to the market that existed for Obamacare, and this That money may be used to offset some of that or you don't. Maybe you would just have the market that existed before the affordable care act, that that is, easy for me to see in a state that applies for. One of these waivers suits were saying that this is weird this.
A much more radical, much in many ways, crueler that the internal politics of spilled way put she's, mostly, although not exclusively by states, is unusual, and I can imagine politicians who you would expect this to come from, but those politicians renown bill. Cassidy, open, sea grab. Lindsey ground is among Republicans, knowing as one of the most by partisan members of the Senate, he's with of buccaneers partner of democratic things I climate change, where he did a lot of work on things like China, close Guantanamo. I he he's somebody who does across the island. He had a lot of criticisms of the process of the previous healthcare bills are pulling. Its put forward. Will talk about process a little bit later, but I do just want to put a pen in that Cassidy is a doktor from Louisiana. He made his name over the last year by being a I ll begin so, as you mentioned, who had a view that you know it of boosting like Obamacare, they should keep it heat
a lot about covered. She went on the Jimmy Kimmel Show and said he wanted anything to passage. He became a test which is at a kid whose born with very, very serious preexisting additions could get very comprehensive coverage for that kid's life would be saved. He has talked about the importance of insurance on one point, did they see a CBS course showing that there are public and bells would not lead people lose cover. German, not increase the death. These are too weak. Wicked senators who you might have expected to come in at the end of this process and say: hey working to try to figure out the bipartisan way to do this, and what's crazy about this to me, is it there actually has a germ about idea in it about I was beat. You knows gesturing towards us we are, but you can really imagine a bell like this, that what it does is it holds funding basically constant it it gives fund it gives state access to whatever funding they would get under Obamacare if they were working to take them and Obamacare. So she's don't have to take the Medicaid expansion that they can, but they don't lose access.
funds, if that happens, and then gives him a huge amount of flexibility in a way that Obamacare it hasn't a virus, but this waivers are pretty hard to use so yeah Californy can traffic single payer or they can keep Obamacare Alabama, can go towards a consumer directed healthcare option of Indiana can expand. What might pence did on Medicaid took something much bigger. You can let all kinds of states go in all considerations of very conservative approach, a very federalist approach. You can put it through a much more normal process. There is a version of this bill that you can imagine, and- and it's funny cause when Tom Price was named Hs secretary- something that I got interest in which he had had an old bill when he was in the house with Tammy Price, whose now Wisconsin Senator Emmi about Henry Baldwin. I'm sorry, because now senator from Wisconsin but she's, a liberal Democrats using the house previously on- and they had this by partisan bill to, let states would have do their own thing. This is pre o bomber cares was in a different context, but it was meant decree.
federalist solution for health care, and I was saying then that that's how Republican should try to deal with a bombing care. They shouldn't make these decisions about subsidy schemes in everything else. It should turn the whole thing over two states and, like that's, conservative, its federalist, it's their law time principles, but it's a lot more appealing and I talked her Obamacare architects. It yeah. You know, honestly. That idea has some appealed to me. It's play better than what I wear Republicans would do. Otherwise, the doktor Republicans who, like that idea, lot and then it's like this every single time they come out with one of these ideas. It is they the cloak it in the rhetoric, federalism of state flexibility of block grants, and then it's all just open mirrors for giant giant giant cuts to spending, and you cannot do good programme without much less money in it without much more and sir, de in it. So I guess it to me is the thing that is just a mystery about this. They don't need to be reconciled.
sure they can at least try a normal process. You have two people here who have quite a bit of credibility among Senate Democrats, so they would be but to get people to work them good faith, and they have the beginnings of an idea here that yeah this could be a grand compromise. healthcare there's enough money coming from the federal government. That states can do what they need to do, but we're not making Alabama do with California does were not making Idaho do it. New Jersey does, and that should have appeal and that's what say they're doing, but that's not what they're doing there actually disk gutting. spending on medicating Obamacare, it's it's bizarre- and it's like the waiter doing, we about process of is irresponsible, but it also just unnecessary. I think that's that's going to process soon But one thing I think so I have had the same thought, but I I don't. I guess what the one thing I don't get it I I agree like I found this idea up healing like if California says it's working, let's let them do it. Let's let Oklahoma do something different
I don't know there's a lot of appetite on the democrat side to pursue anything like that descent. I've gotten from Senate Democrats is that they want, like there, top position right now is that Obamacare in every single states- and they see very little incentive to get behind a bill that lets Oklahoma, do something different and I've kind of I agree with that stands and I think there should be a little more openness to the idea that some states really struggling with affordable care act only have one insurance man in their market. The premiums are going up pretty significantly. You have a significant People are really struggling to pay their plan. So if Oklahoma ones, to experiment with with less robust health insurance plans, like that seems a worthwhile experiment to me. I dont see this path like a grand by partisan compromise, I think a lot of that falls undemocratic to see a way.
Where Obamacare exists in all fifty states and very few reasons to work on a bill that would change that dynamic. I'm melting this wrong a much I'm not sure I think, is probably right. but I do think a lot of that has to do with process process hey listeners, I am here with a message from one of our very smart sponsors, the economist they how much valued their insights into stories that are shaping our world, so there are, all weeds fans, a three copy of the magazine. As someone who loves to get down and the weeds. The economist really gives you a chance to dig even deeper. What's going on in the world, they don't really have a horse so you can trust them to bring you the straight up fast from politics detectors. an environment and, of course, economics and healthcare, the fact We can only get we'd the and so many stories here in the pot gas. So do yourself a favor and visit economists, dot com, slash weeds to get a free sample copy of the economist right. Now they ve got the low
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eight of them right. I mean you need enough to get over the filibuster threshold. She needed your mansions of West Virginia, very home ass cool ass, your highty hide camps I get any immediate from which is not easy. I am not suggesting that easy, but The thing that you would normally do, then, is you would start in a by partisan process trying to do it, and you just take your time right. You it go through amendments. Part because also just makes your bill bettered I've hearings to have discussion to have c b. O analysis I mean, did just go through the basic work of legislating Tay here. The weak spots pointed out to shore up, even if you don't end up getting support, your bill comes out better on the other and for having gone through that the effort to get their support, and so yes, maybe and that they all abandoned you and then you go back to reconciliation and you we write the instructions in a way that makes sense for this bill that you now want to do, because it is worth noting the original reconciliation instructions or public into using. They are not designed for this healthcare bell. They didn't see this one coming.
and if you you would write it in a different way, if you're really trying to get it built like us. So she saying that it's a sure thing they could have gotten them. Cuz hello, I mean, I think it's part of legislating is that you try Democrats tried on Obamacare, they failed, but they did the gang of six. It did all that stuff. He did that. The open amendment process cities. So you try because it makes your bill, but are you try because it shows the public are trying you try, because it gives you time to craft a bill that is actually worth while, as opposed to try. Possible by next Saturday when, like basically nobody it details on this a couple of weeks ago, but then not whether doing their jamming it. In the end of this process and ways, it has some real your weird effects, so so what are they doing to these slightly again. There too, I feel, like I do, give casting credit for some trying earlier this year that he was reaching out to the house in man genes, and it has never, I mean and never got any traction when you have clear repeal bells and build out keep Obama care
partly in play. So you want to give him credit for reaching out to those folks don't say I wanted to get you back a little bit, but I want to push back on me out of it just because what happened there was republican leadership was not allowing that bill to have any process behind it, Let me what was the point of working? I mean the recent MAX pocket. The gang of six thing work is that was a build. Democratic leadership is going to bring to the floor eventually, so investing a bunch a time in it fight was it. You were on the Vienna academic sentence. I think you're right, I'm leadership gets no credit for that aspect. gives up? I do want to give him credit, for you know trying to reach out to demo, senators and this like trying to make this a thing at a moment. No one wanted it to be a thing, desperate fight. I think evolved in like a very different direction, and it's one of them histories of this kind, have been to me like what sort of healthcare system does Senator what, because here one with his name on one we're here considered that the leading republican health want. Apparently because what you are
in February, and what he's working on now just so and day and there. So dear friends, and that's like that there's no come do as he wants one where he's kind of a guy who does republican healthcare policy, cares, is very little about what the actual details of that policy are, but they really are. Two very Different plans maybe gives very notable that Susan, dislike keeping this, I do not want touch this with a ten foot pole at this point where her name is not on it. She doesn't really talk about it. She says she has a lot of concern. This is not the plan, from February. This is a very, very different plan, but let's talk about process, so right now, Republicans are kind of working around the September thirtieth deadline, the reason they are working around a September thirtieth deadline. It is because they ve reconcile, agent Bell and it essentially expires on September three that the end the fiscal year ends this. These
this bill is no longer a vehicle they can use to move at and they want to use this reconciliation bell because it allows them to move something with fifty votes once we get to see October first than they were didn't sixty votes to move any sort of Obamacare appeal package, so that is leading this very bizarre process with very little considering of what is actually in this bill. It sounds like an very brushed process. We we are looking at. Hearing on Monday in the Senate, Finance Committee a Scipios score some time early next week and possibly vote next Wednesday. So it's like process crunched into not a full sepia squirrel say like a preliminary score. That does not tell us how many people lose coverage which Emily I'm thing you would want to know. It sounds like they will get the budget numbers they need to move through the actual check box of moving something to the Senate, but there's coverage numbers because This is such a bizarre bell that Serbia has an analyzed anything similar. This is the sort of belt
take them a long time to work through, but this September thirtieth deadline is kind of, an official you know it is certainly the deadline for passing at this year, but they can do this next year. like there is nothing that says: Obamacare peeled dies for ever and ever? If you don't do this by the end of next week at the start of twenty seventeen after the reconciliation Bell they put in instructions for here. We want you to do excellency and saved this amount of money in committees. Witches Senate speak for these. Of oversight, and you need to repeal Obamacare save this amount of money, they can do that again, in twenty eighteen, ten think when you hear a lot of these things like this is our last chance. This is our last shot. We have to do it now. Our college lifestyle and talk to you lotta vast Republicans There is as thirty nine of them, and this was a lot of their thinking. I think those Pat Roberts of Kansas- you told them- you know this is this- is
last car leaving towns we ve gotta, get it at which, like its unlike City falling apart. Car is like leaving town like well, it may have exploded mile down the road you, parliament, Well, it's my last rides. I better just drive away it, not if those other cars, even town and a couple of days, ratification urgently needed to leave town today, but but but it's coming. This is. a real funny something here. I asked on Wednesday, Graham spokesperson. Tell me why they did it. Why did they marry such huge spending cuts in this bill and also? Why did they just not take a breath? Pull us out of this reconciliation process. Give it really ring is get a real c score like try to I'm open amendment processes this stuff. They both grandma Cassie, said they wanted to see and healthcare process so why are they break in their own promises on this at The commission wrote back to me and said I saw what you wrote earlier today by hadn't written anything, but I think you might have met one of your pieces. Actually it it'll be a wasted.
Hi will be wasted both of our time to talk about this and nobody's even destiny. Is one of these things nobody's trying to defend any of us like this? belike it's the last car leaving town. It's actually not a defence. It's not even a real attempted, a defence. It's a description of what is going on, You know I should up what Bishop set visit was a little bit revealing republic have treated everything here like Just all the normal parts of legislating are a waste of time. They can possibly do like hearing. amendments lino going back and forth. The c b o like I taken the time to sell a bill to the public and try to explain everything you do and they ve. saying that? No? No, we have no time with due to this year under these reconciliation instructions, and it's not true one thing that even imagined, but his mind saying because of the way the counter would work out here because of one they would get, even though
preliminary budget only CBS score and possibly the Senate so then have to go to the house, but because the clock would be about to run out, the house would not be able to amend it s the house who just not have time to mend it. It would just have to be an upper down, So this is a compared to every other bill that we ve talked about in the past, has always had to sing. Like will ya this bill doesn't look good and it was drafted really quickly and nobody knows what it would do, but don't worry, we're gonna go to committee and take some time working out the details that doesn't happen here like this is the most truck hey did jarring of the processes. It's one of the least information. They will have less the CBS score on this bill. Then the age CIA didn't get the final one for their little there, the sort of amended amends. version, but they did have a real CBS score on the main one. I'm does lesson for You should hear this US time to less amending those less time to go back and forth on it. This is No wait a week, configure the american health care system and link
If you listen to what Republican said after Obama and also would Grandma Cassie received during the republican processes thats. What so do like nettled, this is would they described is the way to do this and they don't need to do it. I have a lot of thought and we're gonna take a quick break and we're gonna come back to them I love being able to learn about anything that interest me whenever I want and with the great courses plus, I can do that. I can while these fascinating video lectures and learn from award winning experts about topics that range from world history. Psychology even learning how to cook a little bit better. There are over Eight thousand different lecturers, which means there's always something new to explore one course weeds listeners really enjoy. Is the series on the economics of uncertainty, it kind of shows you the tricked us there Having and thriving in an uncertain economy is to understand the sources of risk and how much of a threat they pose.
led by the award, winning economists conall foreign camp. Any offers these great tools that we can use in all aspects of our lives, including thinking critically and wing risks verses benefits. We want. Our listeners experienced a great ports. plus two and right now they are giving you all and entire month of unlimited access to watch this in any of our workforce. For free. All you need to do is sign up our special url. You can start you're free month right now,. by going to the great courses plus dot com, slash weak, that's the great courses plus dotcom, slash, weeds. So I think someone will be very interesting to watch in this is John MC next week who, as someone who did not vote for the last battle because of concerns about process, but has We been an interval, player and kind of breathing new life into this Graham Capacity Bell
he is someone who is very famously reality it against the lack of process. You know gave this long floor speech about. You know how the Senate needs current normal order. The process around this bill, if it passes, will be everything happening in about seventy two hours, one hearing a partial zedillo score and a vote, because and because of the way, the rules. This is technically being considered as an amendment to the larger and build the better, better care, reconciliation act. Because of that, because it is an amendment, it actually is only eligible for ninety seconds of debate on the floor. So we're literally wager hitting me. Maybe two minutes. I seen different estimates from different walks, but that's it was regenerate a few minutes each side Olga at MAC Sixty seconds to make their case for and against this bell. on the centre, for there will be less debate, though, be left floor debate of this bill than those been weeds, debate of the Spilth Guess so
What we must not we're doing right now is about thirty times longer than the Senate debate. That would happen. like it is I'm right now in the middle of buying a house, it is very possible that they will draft this bill, have a hearing on it, get their personal scorn vote in less time than it is taking me to close on this house, which is like an expensive purchase, but it is also not equal to one sixth of the accounts, may. I am very curious to see how Mccain navigates the next week also the other folks to watch how Democrats watch this, because I think this is setting up. a precedent to do a lot of healthcare legislating. With very let all process around it, and you know I dont know what lessons Democrats will take from it. But you did there. the Sanders Single Pair bell sitting out there, and there is a desire to you know, go further than the affordable care act. That is getting very, very strong that this bill has making sixteen co sponsors, along with Sanders,
interesting to see how this process ripples, when the Democrats, eventually at some points, controlled the Senate, I know a lessons apricots you gonna take it, but I do want to go back to be cared for me, though, because something that that I think is a very important piece of this Linsey Grandma's John Mccain's best friend, If you will the answer to the question of, why might John Mccain vote for this bill? That violates all the reasons he did and vote for the other bill and is in fact, a worse process and, like everybody, was Relieved to see this and gone and and and now we're back is because Lindsey Graphic is like us. And John Mccain. They are incredibly incredibly close and we finally move in. This might have been that the problem of the last bell was, it was not drafted by John begins best friend, and that's not. I think super good reason to remain an american healthcare system. It's not a a compelling health Paul
the argument, but the expectation among most people's John Mccain will not vote against a bill that Graham has drafted in this way, so right now, I think the people who ran Paul has been very he's been very Grason way. He has talked about this bill. You Eve suggests to me that maybe it's warm into posture, he seems very definitive to me, but I don't know, but a ramp all right now, as in the no category, Susan Collins and Leeson were Kuski, which the to them would be enough to kill the bill. I have been very why so Susan College suit of talk about concerns, but has not yet come out against. It is my understanding s and more caskeys, interesting, because this bills extremely bad for Alaska. I'm her governor has come out against the bill the Republic of governor, I'm she's, not come out against the get but said their concern then said she needs numbers she's gonna. Get these numbers in time wonders sub theme of all this is causing.
He's going around two different republican office, where your guy can. I go easy trying to confuse them as far as I can tell so. He he's going ahead with these numbers, it show that all these states get funny increases as the central button Bossy Prodi's pointed out what he's doing comparing his bill to his bill. So it is now, comparing funding under his bill to Obamacare, but he's just comparing like licked his leg. Just like the literal path of funding, this inflation and things like that and so he from what I can tell he's, got a lot of people confused. They think that, like it sounds, equity saying, is funding for all these states goes up under the spell, but compare what they are doing now now, unlike what is going to happen to them under current law, it goes quite a bit down this is one reason I think they do not want. I mean they don't have time to get a conventional budget office score, given that they decided to reduce by next Saturday, but as one and do not want one, because if, when people get a look at the real numbers of s and produce state by state numbers
It's really devastating for, like Alaska and Ohio, I'm very, as should all have surprised inhalers postpone soaring ivy. I think she's, how cosponsor this bill did not understand what it would do at his sponsored a bell, though it be really bad for Nevada, and so the thing that he was trying to do this whole time, which his egg be hip to help with his for popular Governor Brian Sand of all now. of all is fake. Saying has written a letter to Miss MC analysing. Please do not bring this bill to the floor, Indeed, how his name is on the bill, so that's it thing is happening Louisiana where Louisiana Health Secretary, who is a Democrat, sent a letter to the castle singly, please do not bring those built on the floor and be very, very bad for our state. We would not be able to run medicate expansion anymore. see that happening for a few of these sponsors. One of the things that surprises me is the moment. and this has gotten given that it is very poor policy and one that kind
has hung out in the background, for a long time, because kind of been there as dislike beside bill that no ones really getting into, and it first seen liked me was gaining Action causes lively, the only thing that has not yet been rejected, and that still seems to be the case, but again like we're time, or analogy is not a great to get on it, but it also feels like it's happening with attention. Like I don't know. I know that Vox have been covering this really aggressively, but there's an interesting in the Wesleyan media project where chose you're, not seeing the spoken coverage among local news, first, that you did around the other bills. There's lots happening right now. You know I I've been book for a number of the television interviews this week on the bill, all the one have been cancelled because of the hurricane that a lot of the coverage right now. You know I was at CNN earlier today and those like her
Hurricane Hurricane, like tiny, tiny, Ground Cassidy's segments like more hurricane coverage. I am curious how much of that is giving. Republican senators like a bit of yours alone, with less push back from constituents with less coverage of what's going on and the fact this is a really complex bill. Don't really understand what's going to, but what do we do? There is very little analysis of it just because its move so quickly, so we have on the centre in budgeting Z priorities is put out. Numbers Cassidy has put out number, this morning. Another think tank put out numbers, but this data, it has not been readily available. So there's just not a lot of ways to analyze. and I wonder if that is giving republic an environment that it feels a little here to move this forward, with less focus and less understanding of what it would actually do. My impression. Is that a lot of the big coverage spice Cameron CBS Course because those CBS grows gave newspapers like I have seen it
things to put in the article body which a great now it's hard to do in particular Small newspaper in United, dedicated health policy. You know reporters is one way in which doing this without time for real scores, we're gonna get a square like him, I presume later within the budget deficit, because it cuts all this money absent the score that laws these papers to talk about it, I think, as coverage. On the other hand, would you get enough final? Seventy two hour when no, I do you know it looks like it's gonna pass, assume it'll get coverage, but the thing is very, it's very, very depressing, and sometimes like you won't take a step back and say this is really irresponsible to tread We make the healthcare system on a bill that you can even Johnny. Have time and are not taken. I would just get a ceo score on for the house to vote for Billy condemn end
Did it ever? Let's not make this bill is gone through the house, it back to the Senate that you know I mean, as some of you get down at the end you how like. Finally, there is a real up or down both by the house. It never consider this bill. Ever and their lining up, even though I know yes wants to pass any noise and none of these none of these folks and by the way, this includes, in my view, grandma costly, but they have no idea what the spit will do like there has not been. The time is up in the analysis like Cassidy's, This does not like have the the resources to do proper. She's of above, like a folder like us, they just sit there. lining up to transform a system with no idea of what the consequences will be. A lot of the thing about. It is misleading and once I think in some ways it doubly Ripley galling about it. Is it grandma city on their public inside were supposed to be the good guys, like capacity is a small guy, and he has like you know a really interesting interviews with you about health care, and my gram is a guy who cares about the Senate works and like does try to work
Elsie I'll, and it's like there can be tendency to look at their public private eye caught Donald Trump, but you know did it an interview for my mother pike. Us ran Salaam in and he kept her blaming why the process is bad on Donald Trump and end, and you know the fact nobody's ready from to win, but it's not travel but like it's. congressional wing of the party and its not just like the congressional leadership like were now seeing. It felt as all way down into the folks who you would have thought of as like the ones who try to like get this whole thing back on any. Even they like Vries, I don't play, said Graham, typically, does not care about healthcare that much they seem to have gone in themselves. You know locked into this process in in a way that, if the terrible happens in their accidently really and their accidently successful like this is not going to work This isn't legislation that will work and they have not prepared themselves or their party or the states or h ages.
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right now go to get quip dot com, slash weeds, to get your first refill pack free with equip electric toothbrush. That's your first refill pack free get quip dot com flash weeds g t cure you, ip dot com, flash weeds, x in white paper? So we got it and interesting white paper this week its by casts unseen, who you may remember from such a government jobs as regulatory Tsar under the Obama administration, mainly as hits and Caribbean, has a good Sosa, very celebrated law. Professor has written, I think, somewhere between seven nine thousand different books on these very productive guy he's got a pretty interesting white paper. new paper out. It's a pretty. It says at the top. I wanna know very poor preliminary draft, but you can download it at the science research network
it's called unleashed, and this is not one of those math heavy empirical white papers. This is a theory really. This is a long essay on ways in which social change comes from the unleashing of preferences that were there before, but were repressed by social norms or, conversely, new norms create preferences? The didn't exist before so he started to explain these two ideas so the first one which is the unleashing of hidden preferences, which is pretty interesting. He rights under the pressure of social norms, people sunrise false, the preferences. They do not feel free to say or do as they wish once norms are weakened or revised through private efforts are law, it becomes possible to discover preexisting preferences and that's the part of this paper that I think is most directly interesting. At this moment he it does not get into this until sort of the end. But Donald Trump is in this vision
something, what he calls a norm entrepreneur and he is changing norm. is changing what it is. Ok to say, and thus unleashing preference as he is making it, for instance, see more acceptable to be part of white nationals March in Charlottesville, and so he does it get out this pretty directly since being rights in the aftermath of the election of President Donald Trump. Many people fear that something this kind has happened, the basic ideas, if he's a norm, entrepreneurs and he's gonna, We can or eliminate their constraining effects, so he then actually brings up some research. It's pretty interesting showing that, for the election that there was an experiment on people and basically people would donate to an anti migrant group that they wanted to be anonymous and after the election they didn't care about anonymity, anymore. So Donald Trump by changing the cultural Socio play goal. Arena had made. People feel better about expressing and being known for being anti immigrant, and so
What I do think it is interesting about this paper and a lot of pieces of it again to, but is one way to think about what Trump is or could be doing it to the country. Right now, he's not achieved a lot on policy, but I think is achieved a bit on norm breaking, and I think he's made a lot of things and ideas and arguments there. Somewhat verboten in America. Life feel more plausible feel more acceptable, feel like something you can say more loudly obvious he's pretty clear about this. This is what the whole political correctness It is really about, but but something, I think, is a nice job here of attaching into low, but, moreover, grounded fury and how it might work and when things I found most interesting about this paper was looking at the intersection tween laws and norm and how one of the arguments he makes there is that laws can change norms beyond. Just you know, being worth and newspaper the changes, some thing works and he's really interesting. Exam
that I wasn't aware of where he note said I am with the civil rights active nineteen sixty four, some, the restaurants in hotels were regulated it actually lobbied in favour of it. So this is a restaurant that presumably could have integrated that could have served widened customers? There is no law saying this is not allowed you have to segregate, but he knew he makes the point here. Is it not really aware tat it through in this kind of an interesting shift for me was, you know, they wanted to be able to point to the law. They want to be able to say, look like this is how things work like this is DA. We abide by and its good business. That right like this, is a restaurant, though, like to sell food to as many people as possible, so it is in their economic interests to have to be able to serve african american customers, and I thought that was issued an interesting way to think through how how laws can chew, the norms that it's not just a new regulation. But then you see this shift
what is a normal, acceptable way to see or consumers, and even if that something that was sort of their but a hidden preference, but or that the law has actually made at a public preference, and that is, he argues, can have some cascade of facts to people who then see in a black and white people eating and the same structure, and I think this all gets to this. This political correctness debate, which is complicated debate and has been defined in almost its language in a very certain way now so political correctness is itself it has, I think the turn in something of a slur right of your being politically correct. That is, nobody ever means. That is a good thing over in Berkeley last week or right now or something there is a there having birthday free speech week, which is out of a sort of conservatives, some of whom have pretty repellent opinions out their sort of framing what their due. Not even under like their own opinions, but under like a defence of free speech and services. Hold dialogue have
right now about how important it is to be able to say anything and end. The defence for some of this stuff is like not even that is right, but just that it back If we're in a politically correct society were some things are discouraged, but it's a case in any society at any time be have some speech. It is celebrating some speech. It is discouraged totally supper by their, not you're free to make that speech. This is a long time view of conservatives who have forever. You know had speech they liked and speech they didn't like is also view liberals and we're in a real tussle right now about what kind of speech in and we are going to accept and what kind of speech we're gonna sanction through through criticism and I think that we are having a lot of trouble just having that conversation in a clear way I think we're having a lot of trouble
a real fight right now about just how do you about what how much sensitivity people should have in referring to transgender folk, so girl there conservatives who, for reasons I do not understand, really do not want to accept that Chelsea Manning has changed her gender and wants to be referred to in this way and just referred or the way they wish. You want to be referred to them. That is not a reasonable speech claim and to a lot of other folks like no like that should be a normal basic thing of politeness, like you know, like just a b Sent to one another, I think we ve had a lot of trouble in the country most couple years, having a discussion about speech where we I agree. We have quite broad to constitutional protections for free speech but also we should be a little bit more clear eyed about the fact that it has always been the case that one way social change happens is that some speeches celebrate it, and some speeches made
light. I am not really allowed to ground, my office, cursing people- I'm not allowed to walk outside an increase of people. Now it may not be that's what I'm doing The legal though, depending on how you do it, I guess it could be, but we just have now arms and those norms are built for reasons, and I think what sense it is. A good job in Spain in this paper is noting that when norms begin to fall or when norms begin to change, it can really change what is acceptable in society very fast. Because often times it turns out that where society really was was in some way repressed or shaped by the norms in which we were ignored, the answer he uses as an example right up at the top conversation he had with a student who he sought student to law school student, he sought in talking to an order, professor and basically being mildly, sexually harassed, and you know who
not consider they haven. T look ok to me and in issues I dunno it's fine, but then she comes too late, as I know that action I find it all, and just by being a professor who changed the norm to hurling actually can criticise us. He allowed her real preference, her real view, which is like actually feel terrible, this and I've just been your mildly assaulted in my place of learning to come out so this idea, like there being hidden preferences, I think it is really usefulness, useful way of thinking about norms and what societal news about which speeches acceptable and which speech is discussed, yes or unkind or regressive, I'm what it's actually doing when they think it hidden go there, but it felt like to me there the bit of an intersection with a lot of the real to think you were none more and I for none of that, a bit looking at tribalism and how kind of people But what is the norm where they lived? His lot of this is written kind of big again. This is a preliminary draft, two in big picture
how norms change in the entire country, but I think, like in the flip side of that, is seeing norms, change in different places and very different people having very different set of norms that they Braden I've you. I think back to the reporting I've done in Kentucky about before correct- and I think there is the norm to say- like Obama cares about law, and I think it should be peeled and that it, and that is a norm. You hear from everybody else when the things it's unseen rights in this paper is how you see he's kind of norm cascades, person. One says well bomber to while it premiums another person like might disagree privately, but they're not going to express it. because you know the norm is that this is a bad law When you have all these people, suppressing or some number of people suppressing the view that they actually hold because they understand the norm is quite different. That thing like I'm kinda, you think about it, as you read a lot of this research, but that it seems like this could also be a way
could be a theory that helps explained the polarizing. and how you happy living in different places, thinking very very differently about the things they are observing job slowly in so one way, which I think it is really explanatory though the world were in, is to imagine that different tribes, different communities, different groups, they have different, obviously preferences and they have different eternal. terms what is ok to say and do and ways to act in Manhattan is different than what is ok, say and do and how we should act in rural Oklahoma. I mean even in very small ways the amount of time that you wait, while somebody's paused speaking in New York, city and polite conversation and the amount of time you wait when somebody is pause. Speaking in the south are just very different and it creates a lot of confusion when people from New York talk to people from the south in a lot of feeling of your presence being rude, but in their world are not being rude like you just wait. Last time
but when they then go to Kentucky their interrupting people constantly, so that of a funding mystic finding boat. But this is true, Broadway, and something that I think is happening as it were in a period of norm, flux and appear to very contested norms. So how do you talk about the thing about gender during the election is having a really good version of this, her a good way to think about it. You have one political, coalition. There really is trying to say: hey, you know you there's a lot of implicit bias in the way you talk about that stuff. I mean one thing that you sell playing out allowed in initial, listen during the election was criticism of journalists who would comment a lot on what female politicians, Hillary Clinton, but not only Hillary Clinton, were wearing right and the note the like, while mail. Patients don't get all this like. Are they a gray suit or not today kind of stuff, and you know there will be pushed back on us and a feeling of hay like I'm. You know
this is normal, like people been doing this for a long time, but this was a place where, because norms changing a long time view was starting to be able to be expressed right. There been a preference a lot of journalists and and and and the lot of folks in politics. Many them women too, maybe not have it be normal that female politicians get Chris sized or assessed by their appearance. In this unusual way, as I came out there, there was backlash, I I think one of the things right now is that the tribes are colliding a lot more there kleidung online, because everything goes viral on Facebook. There kleidung a politics, because politics is much more nationalized and it used to be there kleidung, because Do you spend a lot of time elevating places where, like like a liberal group on camp he's trying to establish a new norm- and you know, emphasis you spend time on on the opposite, and so one of them, difficulties. Is that in this related, what this paper sensible? Not exactly at? Isn't it
One way you might imagine he stood terrain across the land is that different groups have different. Libya Amber right now. I think, though, that's become a lot harder to become particularly hard on politics on the internet, so that if the groups are coming into a lot of of conflict arms, All things are getting blown up. Suddenly everybody knows, but something happened. It Oberlin College or in Charlottesville right, where back when we have less nationalized media unless internet it just would have been hearted? Have this information and so there's a lot more of an effort to try to create a more national norm about what, having can say, which also means a more national said of opinions at our okay and an end or not. Okay and vat creating a lot of friction. Donald Trump, explicitly run saying no. You should be able to sell the stuff that we should not have the storm that this set of norms that you're trying to put down, even if you,
try to put them down in law like it should be fine to talk the way I talk and help and monopoly. That should be fine to talk the way, Donald Trump. but Eliseo Machado, cholera, fat, pig and all the stuff, but where it used to be, maybe that way that would be dealt with is like just one tribe, One said in another would have another now: there's Israel conflict and and leading to a lot of tension and anger and our politics. I agree, you know it make our politics better if everyone, the centre, the we adhere people less. If recommended the weeds, their friends scented by e mails, you can send we'd swayed e mails. Can you Thank you. I guess you could say that they will be linked to the Itunes egotist right. Please go listen to the weeds that wherever you find your fine by gas of Eid, monotone arm in your community, that everyone doesn't so that we do noakes having weeds listeners, might might have some folks like this, and we are looking at box for a policy editor. I If you are an experienced added or listen to the show, and you love the idea- the stories on picketing science
papers and Casan steam papers and Graham Cassidy and all the weeds things we talk about. You should a box meted out Comstock Careers out where we have the list. that again, that is, box media dot com. Such careers we have policy job up with a bunch of other jobs up for writers and and video makers and all kinds of things, but I think so you all in the audience might be interested yeah. Well, thank you So much for listening is always you can find. The discussion continues and our Facebook group, which of you just search for the weeds, you will american related things, but you will also find our fantastic facebook group think Peter Leonard are producer. Thank you as refer coasting today with me. and we will you back and Friday, he we Those nurse thanks again for turning into this episode. We wanted to take this moment to insert a shameless, well actually very proud, plug far parent company vocs media
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Transcript generated on 2021-09-13.