Who Shut Down What, Now?

But, That Unicorn Thing Sounds Nice…

I’ve run into a few friends who haven’t really heard what’s going on with the shutdown, so I wanted to address it in terms of what’s causing it, rather than just who. (And with one of my ‘fundamental paradigm’ theories!) Apologies if you’re already aware of all this.

The ‘One Big Beautiful Bill Act’ passed by Republicans in July, while giving ICE/DHS $170B alongside huge tax breaks for the rich, also cut $1.5T from MedicAid, SNAP and MediCare.

So, let’s talk about healthcare.

We’re all hearing the current BS line going around that Democrats have shut down the government because they want to give illegal aliens $1.5T in free healthcare. (That number sound familiar?)

Also, they want unicorns named as the national animal and increased leprechaun protections.

Well, they might as well, for all it matters to Republicans.

You see, the GOP was supposed to come up with their budget and pass it by September 30th.

They didn’t.

So, instead, they put up a CR (Continuing Resolution) to kick the can down the road a few months. Democrats are filibustering it.

Why?

What do they really want?

First, some scene-setting.

~How the Hell Are We Here?~

The real nuts and bolts of it is that the US is possibly the most expensive healthcare nation in the industrialized world. We likely pay more for healthcare than anyone on the planet. We have the highest price prescription drugs, the highest prices for hospital stays and obscenely high prices for medical equipment. (And, for using it.)

As soon as medicine was made a for-profit business in the 70s, it became an extortion racket. It immediately became necessary for all but the wealthiest people to either work where health insurance was provided or make enough to buy it on your own.

The cost was so vast it could only be handled for most people by insurance pools. Even 50 years ago, a car accident or a major illness could cause bankrupting medical expenses.

It’s even worse, now.

Medical expenses are still among the most common causes of bankruptcy in the US. You would think that by now we’d have some way around this.

Well, we have.

Sort of.

We have three options that make healthcare possible for many of those who can’t afford modern costs. They are, of course, MediCare, MedicAid and the ACA (Obamacare).

They are the main subjects in the Democratic filibuster of the CR to continue the Big Bad Bogus Bill from July. It slashes $1T from MedicAid and SNAP, and because the bill still increases the deficit, it triggers another mandatory $500B cut to MediCare. And, importantly, it lets the ACA subsidies expire, which will send premium costs soaring through the roof for some 35 million people.

Now, we take as given that Republicans have always been trying to destroy them, and social security, all welfare and apparently any services that aid individuals, especially low income or minority. What we don’t know is what the fuck is wrong with them.

Because only an asshole doesn’t want sick people to get help. But, there’s more to this than meanness.

There’s also stupidity.

The two most common right-wing complaints are;

1- “I don’t want these moochers getting free stuff off of my tax dollars. I’m not paying for their health care.”

This is really absurd because every form of insurance is based on everybody’s premiums paying for whoever needs help now. An insurance company is a wager that premiums will outpace costs.

In that regard, MediCare and MedicAid work much the same way- our tax dollars are pooled into a budget for it, and it’s distributed to medical providers as charges are incurred.

This is precisely how universal healthcare, or ‘MediCare For All’ would work, and why it works everywhere they do it.

And, 2- “You can’t make doctors work for free!”

Which is even more absurd, because, obviously, no one demands that.

But, there’s another very important reason why these ideas work, and why the oligarch right wing doesn’t seem to get it.

~Here Comes That Fundamental Paradigm Shit I Warned You About!~

It’s the concept of outcome-based business.

All insurance is income-based. Premiums are based on profit margin above spending trends. They have margin targets and will raise prices or reduce coverage if that margin is in jeopardy.

But a genuine non-profit organization is not based on income- raking in profit- but on outcome, because they plan to spend all the money on the purpose.

If a soup kitchen gets more money, it serves more soup. It’s not ‘how much donations did we take in’, but, ‘how many people did we feed?’ And ‘how many did we miss?’

Any rise in earnings is applied to doing more of the thing you do for more people.

I’ve never seen a Republican who can wrap their head around that.

But, MediCare, SNAP and MedicAid are outcome-based entities- they seek to help the most people they can in the most ways. This is how all universal healthcare works around the globe.

But, it doesn’t matter that these entities are outcome-based, because the companies they have to deal with are not.

They are practicing margin-first business with the government and they love it. They’ve turned the medical industry into a vendor heaven, with thousands of tests and services all outsourced and spread across a vast network of clinics and doctor’s offices.

This is where the fraud lies, in the new growth of billing opportunities with MediCare-Plus plans. While they largely provide useful services to the consumers, they are billing the government at top rates for everything they pay out for.

No consumer profits monetarily from receiving MediCare or MedicAid, but many companies profit greatly from billing them for services.

A brief glimpse of a fix was the Obama-era law that let the government negotiate drug prices. It led to a noticeable reduction. But, Republicans did away with it, and prices went back up.

And, those ACA subsidies- people don’t get them- the insurance companies do. They are literally reimbursed for whatever discount they give you. That’s why premiums are going up by 100-200%. They were never discounting anything- the government was just paying the lion’s share of it. Now, the patient has to pay that.

So, Democrats figure, if you’re so willing to go trillions more into debt for billionaire tax breaks, the least you can fucking do is leave your goddam hands off of healthcare. (Well, they haven’t said that exactly, but, don’t you wish they would?)

So, that’s what they’re asking for, and there’s a hell of a lot more rotten shit in that bill that they could be yelling about, but this is the most drastic arena and it also affects major swaths of tRump voters.

After shutting Dems out of the process entirely and passing it on a pure partisan vote, even in the Senate by disingenuously using reconciliation, Republicans refuse to negotiate or speak with Dems at all. The most they’ve offered is further even more disingenuous votes that will fail by party lines anyway. They have left Dems with no alternative but the filibuster to force any kind of action.

If Dems did just let the CR pass and tried to propose these restorations in regular session, they’d be blocked, of course, and all these cuts, millions of people losing healthcare altogether and hundreds of rural hospital closings, will go on as planned by the GOP.

Democrats have been given no reason to consider any Republican offer in good faith, as they’ve failed it every time. By using the filibuster, Democrats have given Republicans only two options- negotiate a new version that restores healthcare funding and the ACA subsidies, or ‘nuke’- eliminate- the filibuster for CRs, which the GOP doesn’t want to do because then they can’t use it either.

You’d think Republicans would be relieved that this was all Dems want and go ahead and do it and look like patriotic bi-partisan heroes to their base.

No, seriously.

All right, even I couldn’t hold a straight face on that one.

But, even if hell froze over with pigs flying above it and they did, it would have to go back to the House.

And Speaker Mikey can’t have that. He’d have to open the doors and call in an actual session, and the moment he does, he has to swear in new AZ Rep Grijalva, and the moment that happens there’s 218 signatures on the Epstein Files release petition, and you see where this is going.

And, even if Mikey got past that and had a vote on the new Senate bill and it passed because half a dozen Republicans understand what the hell is going on (I know, right?), then it would go to tRump, who would veto it because Dems give healthcare to illegals.

It wouldn’t, of course, but he would never actually read the bill. (He probably can’t.) Still, he would go on TV and say that anyways.

Because he likes the shutdown. He loves Mikey’s ultimatum that he won’t open the House until Senate Dems capitulate. He really loves lying about, well, anything, but, especially about Democrats. Look at how many late nights he’s spent making up names and degrading accusations about them.

But, most of all, having the government shut down and blaming it on lies about Dems is affording tRump the opportunity to literally take a back-hoe to the nation.

Shutting down billions in vital government agencies and funding, firing thousands of workers, sending his masked ICE/Gestapo into blue cities to detain thousands of latinos without any due process, grabbing hundreds of citizens and legal residents, and outright bombing suspected drug boats too far from the US to even get here, brutally killing 43 people with no effort to stop them or identify them.

Now, he’s even gone and torn down the East Wing of the White House, including the Jacqueline Kennedy Garden.

Functionally, he’s already a dictator, because only a dictator would get away with any of this shit, or even want to.

But, the reality- the world they’re dismantling for their fascist facade- is that the US government was never meant to be run as a business, hence all of the separations of powers and responsibilities designed to minimize corruption. Remember? Checks and balances?

Our Democratic Constitutional Republic is, by design, outcome-based. (You knew we’d come back to that.)

~Oh, Yeah? Prove It!~

The best example, and one of the most harassed by Republicans, is the USPS.

Yes, the Post Office.

It’s mandated by the Constitution to be established and run by Congress. It is outcome-based. Congress is supposed to budget and add post offices and workers as are needed to satisfy delivery of all the mail to all of the US.

That means that even little podunk towns in the middle of nowhere must have access to the mail. It could just mean assigning a local merchant to act as post master- like TV’s iconic Sam Drucker on ‘Petticoat Junction/ Green Acres’. Or, it could be a small office with one or two workers. It would depend on the population, and a boom would mean a bigger Post Office.

Even the major delivery services- UPS, FedEx, et al, don’t go everywhere. There’s a point where they hand things off to the USPS. Like, that little podunk town.

Now, Fedex would never put an office in that town if it didn’t have enough population to meet their margin. But, thanks to the USPS, their clients can still pay them to send things there.

It’s because the USPS doesn’t have a profit margin to meet. They have targets and expenses, and need enough revenue or congressional funding to meet those needs.

The irony is, that for a long while, it was profitable, earning an average of $1B a year up until the early 2000s, when Republicans began hammering on privatizing it again. Then, in 2007, Bush2 leveled an absurd cost on them, pre-funding their pension plan 75 years into the future in ten years time.

Of course, this made the USPS look like a loser, and, by the time it expired in 2017, email had replaced large amounts of hand mail, and tRump was in office, sending Louis DeJoy in to decimate the service, actually destroying several expensive and vital sorting machines during the 2020 elections.

Because he can only see it in terms of profit and power.

But, like MediCare, SNAP, MedicAid and the ACA, the goal is not profit, but reaching everybody that needs to be reached. You know, “the mail must go through!”

Doctors get paid by these government services just like postal workers get paid by Congress. At that level- personnel, wages, facilities, equipment, education, etc.,- they’re no different from any other outcome-based industry.

Removing the profit margin, making the medical industry non-profit, would open up the kind of spending we see at the USPS. Hospitals, doctors, nurses, all hired and assigned according to the local population’s needs rather than margin goals.

Folded into taxes, the cost can be much lower and fairly shared across the income spectrum. That’s the way it works everywhere they have universal healthcare. The increased tax is far lower than the a la carte cost of healthcare.

In the meantime, the cuts Democrats are fighting to restore will cause hospitals and clinics across the nation to close, especially in red rural areas that voted for tRump. And a majority of people using the ACA Marketplace are in red states, and they will feel the brunt of the subsidy repeals. By 2027, that little podunk county will have no hospital.

~So, Is It the Dems ‘Shutdown’?~

Well, in the strictest terms, yes, because their filibuster has passed the deadline and continues. If we want to blame it solely on their refusal to capitulate, then yes.

But, if we look at why they’re doing it, it’s clear that this is the only way they can force a meaningful vote on an issue that bodes dire consequences for millions of Americans, many, the GOP’s own voters.

Reality, as we knew it, was that the New Deal Era developments were helping. Expanding them was a good thing.

But, sadly, we don’t live in reality anymore. We’re inundated with profiteering, crimes, lies and outright violence in furtherance of a graft and terror-based fascist regime.

We need to get back to our Constitutional outcome-based roots. Dems want to start with healthcare. I think that’s reasonable.

So, we can blame the Democrats for making a stand, but we can’t do it without also wondering why the hell Republicans won’t just give them this bone. It helps their own voters even more than it does Democrats, so why won’t they do it?

You know. (Nudge, nudge.)

Man, we really gotta get these assholes the hell out of our government.

C.2025 Cousin B