Jeb!

As I continue with this series of blogs about the Presidential candidates, I wondered if I should even do Jeb Bush. After all, the utility of such a project is in telling you about candidates who might actually win. Jeb Bush entered this campaign as the prohibitive favorite of the Republican establishment. It’s just bad luck and bad timing that this election cycle happens to be one in which the electorate is completely fed up with the party establishment. Jeb! has been plugging along at around 3% in the polls, getting humiliated in the debates and spending buckets of money with no results to show for it. It’s become a comical campaign, especially for a serious-minded, issue oriented candidate. And the harmless affectation of that exclamation point on all his posters and literature has become the punch-line for late-night comics.

Still, he could win. It’s not impossible to construct a scenario in which his massive campaign war chest actually starts to mean something–a decent showing in Iowa, a comeback third-place in New Hampshire, maybe a South Carolina win. None of that’s likely; none of it is impossible. And he’s supposed to be the wonkish Bush, the issues guy, the thoughtful candidate. Let’s see how his positions stack up.

Let me also say that I really like his website. (The best that money could buy?) I like the way he divides the Issues section up into further subcategories: Safer, Stronger, Freer. It’s easy to navigate, attractively presented. And when you read the actual issues’ statements, the good ones are in first-person, and are well-written and smart. On border security, for example, he demonstrates a solid sense of the actual challenges faced by the border patrol. The point of border security is not to keep everyone out; it’s to prevent drug cartels from moving product. He proposes a complex combination of strategies–better roads and infrastructure, electronic surveillance, faster transport vehicles. The emphasis is on flexibility, quickness, rapid response.

That section’s solid and smart. The section on ‘defeating ISIS’ is much less impressive. It’s not in first-person, suggesting a lack of engagement. What he can’t say, really, is that ISIS is essentially the inadvertent step-child of his brother’s policies. What would he do about it? The real question is this: would Jeb Bush send ground troops to defeat ISIS. He doesn’t quite say, but statements like “make better use of US ground forces,” no longer crippling their efforts with “overly-restrictive rules of engagement” are clear enough. Call me cynical, but he’s a Bush; he’s going to send troops to the Middle East. Again.

On the economy, we get sheer mendacity. Here’s the key statement. First he talks about our current poor economy ‘barely growing at 2% a year. Then he says this:

I have proposed pro-growth policies designed to achieve 4 percent growth, create 19 million new jobs and increase middle class incomes. I know these policies will work because I did it in Florida. We lowered taxes every year I was governor – totaling more than $19 billion. We reduced regulations and cut the state bureaucracy by over 10 percent. These pro-growth policies made Florida number one in small business creation, helped create 1.3 million new jobs and increased middle class incomes by $1,300. We can create similar job and income growth for the nation.

So, we look at this, and we’re supposed to say to ourselves ‘wow. That’s an impressive record. And a 4% growth rate would be terrific! So what’s the problem?’

The problem is, we’re not idiots. Jeb Bush was governor of Florida from 1999 to 2007. Florida, like the rest of the nation, benefitted, in 2007, from a bubble economy, built on impressive growth in the real estate sector and in the sale of CDO’s in financial markets. In 2007, it all blew up. In 2008, the US and world economies nearly collapsed altogether. And we all know that! We were there! And we haven’t forgotten! (Nor have we forgotten that your last name is Bush. Unfair, but . . . .)

And that tepid 2% growth rate? That’s for the entire Obama Presidency, including 2009, 2010, 2011, when the President was trying to save an economy trapped in the Great Recession. The current rate of economic growth right now? 3.8%. Close enough to the 4% that Bush holds up as the standard to which he aspires. Which he suggests can be achieved by more tax cuts, and more de-regulation. The very policies that caused the Great Recession.

So, no thanks on the economy. His plans are to bust the budget, and create another financial crisis. I’m not being fair, of course, but neither is he. His impressive economic record is entirely the result of one factor; he got out in time. And we all know that’s true. So is there another section where his celebrated intellect might shine a bit more clearly?

Health care? I read his section on health care with some interest. Obviously, he loathes Obamacare; he’s a conservative. What he do instead?

You have to read between the lines a little bit, but basically, he wants a version of the ACA that also provides people with crappier insurance. All the things people like about Obamacare are part of his plan. No more denial of insurance for people with pre-existing conditions. Portability. Exchanges. States offered incentives to expand Medicaid. Federal dollars subsidizing premiums. That’s all Obamacare.

Here’s the difference: “enabling access to affordable, catastrophic plans.” It turns out that that’s his problem with Obamacare; insurance plans purchased on the exchanges are too expensive. And they are. Nobody really questions that. A lot of ACA exchange insurance companies lost money initially, and raised their rates. He wants to solve this problem by allowing insurance companies to offer worse policies. ‘Catastrophic’ plans. Which is to say, insurance plans that offer no benefits for most, normal, health issues, but that do kick in for really big-ticket emergencies–cancer, heart disease, serious accidents.

It goes without saying that rich people get better health care than poor do. That’s always been true, and will continue. But to some extent, Obamacare leveled that playing field. Families on ACA exchange policies got coverage for preventive health care; antibiotics for an infection, regular check-ups, x-rays in case of an injury, or an MRI, or a CAT scan for other conditions. Jeb! would get rid of all of that. If you’re in a poor family, and your kid got cancer, that would be covered, though with a high enough deductible that you probably would be bankrupted. But if she broke her leg horsing around in the back yard, you’d be on the hook for x-rays and orthopedics.

Bush’s plan would cover some of that through HSAs; Health Savings Accounts. They’re sort of a hot conservative idea. It’s a tax-advantaged medical savings account, and it would roll-over year after year, and accumulate. Conservatives like HSAs, because they make people accountable for their own health care–it encourages you to shop around, and it removes insurance companies saying nasty things like ‘that’s not a covered benefit.’

Here’s why they don’t work: We The People don’t know enough to be smart consumers. There’s an asymmetry of information at play. I’m likely to agree to a medical test or procedure if my doctor orders it, because he knows what he’s doing, presumably, and I don’t. Now, this could mean doctors ordering unnecessary tests or procedures, especially if they profit financially by them. I honestly don’t think that happens all that often. I see many many many doctors, and I’ve never had the tiniest grounds to question the basic integrity of any of them. I do sometimes question a diagnosis or treatment; I try to be an informed patient. But I am fully aware that their training and knowledge exceeds mine by a considerable degree.

And there’s no way to solve that. Oh, there have been attempts; Houston’s 2nd Opinion, for example, a web-based service where you can ask other doctors for another analysis. It doesn’t matter. Information asymmetry is still the most salient fact about health care; doctors really do better than we do. A ‘market-based’ health care solution–the conservative Holy Grail–isn’t really achievable. Medicare works; employer-based insurance, sort of works, Obamacare will work, in time. Not much else.

What Bush tacitly admits here is that Obamacare, with all its flaws, really is a workable approach, but that it also needs tweaking. Increase the premium subsidy, for example. Tell states to stop screwing around with Medicaid. But lousy insurance-plus-HSAs (essentially the Bush proposal) won’t work. Unless we really do believe that poorer people should get rotten insurance. “If they’re going to die,” said Scrooge, “then they had better do it, and decrease the surplus population.”

So, this is what wonkish Republican establishment orthodoxy looks like. Budget-busting tax cuts. A new tax code favoring rich folks. More ground troops in foreign lands. Crappier insurance for poor people. Jeb!’s website looks great, and there are some good ideas there, on immigration reform, for example. But mostly, it’s a testament to the intellectual bankruptcy of the Republican party. On the campaign trail, Jeb Bush doesn’t particularly look like he wants to be President. Good thing he’s probably not going to be.

 

One thought on “Jeb!

  1. Chris Williams

    “x-rays in case of an injury, or an MRI, or a CAT scan for other conditions… orthopedics….”

    Current Obamacare plans don’t cover x-rays or orthopedics, or any of this stuff until your deductible is paid. My deductible is 10,000 dollars.

    We pay for all injuries, lab work, any visits that aren’t preventative. If yours does cover all that, I’m in the wrong job. 😉

    So Bush’s plan is no different.

    Reply

Leave a Reply