12 Comments
User's avatar
Johan's avatar

This isn’t policymaking, it’s sabotage dressed as strategy.

From a behavioral lens, what we’re seeing is incentive inversion: weaponize dysfunction, then blame the fallout on the very systems you’ve undermined. The goal isn’t to fix healthcare. It’s to destabilize it just enough to justify repeal. And when gerrymandering insulates power from consequence, cruelty becomes costless.

As I’ve written also in Cruelty as Strategic Export, the erosion of public goods isn’t accidental, it’s engineered. The louder the denial, the clearer the intent.

Thanks for keeping this going strong.

— Johan

Professor of Behavioral Economics and Applied Cognitive Theory

Former Foreign Service Officer

Expand full comment
Nancy's avatar

It’s a well written and persuasive overview but I’d disagree with one claim: that Medicare will be untouched. There have already been attempts to impose obstacles to accessing traditional Medicare coverage (not the privatized Medicare Advantage ).

Expand full comment
Richard Brody's avatar

And for this possibility we must keep up the fight.

Expand full comment
Diane Bisson's avatar

It is frightening to see this laid out in such a clear fashion- and I can never understand why the majority of the Republicans in power seem to hate the fact that so many Americans are able to have access to healthcare under the ACA (I wish we would drop the name Obamacare as they sneer when they say it), and as their constituents are in the highest percentage of enrollees they demonstrate how little they care about them. If they truly want another option then stop taking unnecessary vacations and start doing the hard work of actually developing a different option!

Expand full comment
Richard Brody's avatar

“Obamacare” is Trump’s favorite pejorative. Followed closely by Bidenomics. Blame your predecessors who are no longer your opponents in an election, stirring the pot of bigotry and hatred to appeal to your baseless base.

Expand full comment
Jennie Edwards's avatar

This regime has zero morals or values other than kissing Trump's ass as frequently as they can. Concepts of a plan is the best they can come up with! ✌🏼

Expand full comment
Michael Chaskes's avatar

I hope your worst case scenario doesn’t come to pass, but if it does, I don’t see how Repubs will be able to fob the blame off on Democrats or the ACA itself. They control the government lock, stock, and barrel, and Americans have by and large come to appreciate the ACA.

Expand full comment
Goldfish's avatar

For the ACA, don't forget that it had a generous pilot in Massachusetts before rolling out nationwide.

Expand full comment
Michael Chaskes's avatar

And under a Republican governor, ironically enough. Trying to nationalize THEIR own preferred market-based mechanism for expanding coverage was intended as an olive branch, one that national Repubs wasted no time in trying to shove up Democrats’ a**es.

Expand full comment
Lisa Woods's avatar

HCR the other day said 'republicans' are so used to saying NO! that they don't know how to govern. This is true. That l find myself agreeing with MTG as she asks "where's our health plan?" just shows what an upside-down world this has become. As your article states, most of them don't care about those who would lose coverage. 😔

Expand full comment
Richard Brody's avatar

“Fixing” healthcare is like fixing a bet, cheating the system by removing coverage for those who need it most. Legislators get free healthcare and many are numb when it calls to protect citizens- and their voters- from the ravages of a clueless president. As the saying goes, stop the steal.

Expand full comment
Steve's avatar

If illegal immigrants are stealing healthcare, then why haven't the republicans, who totally control the government, arrested them? 🤔

Expand full comment