Patched Up? Or Patched Over?

What Speaker Ryan said on 60 Minutes last weekend about letting “bygones be bygones” with President-Elect Trump may only be partly true. There are certainly contradictions within the Republican party as a whole. But as between these two individuals, both ready to wield powers granted by the Constitution, the proper word would be “confrontation,” not dialectical “contradiction.”

How so? It has to do with their alignments to differing factions in the party. Speaker Ryan is a fiscal conservative. For example, he is planning to reduce the government’s share of the cost of Medicare. Democrats say he wants to “privatize” it, making it a system of health care premium supports or vouchers, rather than an entitlement to government funding. In this equation, the amount the government would save is about exactly equal to the extra amount seniors would have to cover out of their own pockets. But maybe that can be considered “responsible.”

The one thing fiscal conservatives hate worse than entitlements they can’t get rid of is government debt they can’t get rid of. That is, they hate “borrow and spend” and didn’t care for it much even when all the governments of the Western economies were doing it in order to get out of the Great Recession.

Well, on second thought, there’s one thing they hate worse still: “tax and spend.” But Trump isn’t going to do that. He’s going to reduce taxes.

And build infrastructure. And make the military “great” again. But how’s he going to pay for it? If not tax and spend….

He has to borrow and spend, doesn’t he? What fiscal conservatives hate but blue collar workers might love. Trump’s no social conservative, but enough social conservatives sucked it up, voted for him, and got him elected anyway – with the help of Trump’s new, blue collar Republicans.

But is he a fiscal conservative? That’s in doubt, because if Trump wants to spend but not tax, he’ll have to borrow. Moreover, he promised on the campaign trail that he would not “touch” entitlements. Today, with the party ready to take firm control, it may look to some like everything can be smoothed over and worked out. But when push comes to shove (and I say this as a judgment of personalities not as a conclusion of dialectical logic), there will be some pushing and shoving. And the Democrats won’t just be standing around watching.




Welcome Mr. Seidel. It's nice to have someone else posting here besides me. I hope you stick around.

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Dan E. Phillips, MD


I've been dealing with caregiver issues so hopefully more articles will be published than has been of late.

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I was referring specifically to Instapopulist. No criticism implied. Hope all is well.

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Dan E. Phillips, MD

Instapopulist is all yours to do with the space as you wish

It is all yours and goes out to the feeds but the articles help bring in readers. I should write about the economics of long term care, costs and lack of real care.

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