Using Doublethink To Sell Trumpcare

Still from “Nineteen Eighty-Four” (1984)

Tuesday

How do you sell a healthcare bill that has a 17% approval rating and may throw as many as 24 million people off their healthcare plans? According to New York Times columnist Paul Krugman, you use Doublethink:

What really stands out…is the Orwell-level dishonesty of the whole effort. As far as I can tell, every word Republicans, from Trump on down, have said about their bill — about why they want to replace Obamacare, about what their replacement would do, and about how it would work — is a lie, including “a,” “and” and “the.”

Brian Beutler of The New Republic sets forth the four major lies that the GOP is using to sell the bill. They are:

Claim: We’re not kicking millions off of Medicaid.
Fact: The Congressional Budget Office estimate of an earlier and less severe version of the bill estimated that AHCA “would reduce Medicaid rolls by five million people within a year, and 14 million people over 10 years.” 

Claim: We’re not screwing over sick people.
Fact: Insurance companies will be allowed to raise rates on sick people to such an extent that many with preexisting conditions will not be able to afford health insurance, returning them to the pre-Obamacare days.

Claim: We didn’t end-run the Congressional Budget Office at all!
Fact: The GOP rushed the vote so that they would not have to face the estimates, which are expected next week and will probably be brutal.

Claim: Health insurance doesn’t save lives anyhow.
Fact: As Beutler points out, “People without insurance put off doctor’s visits and stop taking expensive medicines all the time. In some of these cases, such as undiagnosed cancer or worsening heart disease, the consequence of the delay is death.”

So what’s going on here? Krugman suspects, and I agree, that Trump’s fabricating has proved so successful that the party as a whole is adopting the approach. After all, why not use what works?

Orwell called the approach Doublethink, which involves upending people’s sense of reality. Winston Smith learns from a party document that Doublethink is “a vast system of mental cheating”:

If one is to rule, and to continue ruling, one must be able to dislocate the sense of reality. For the secret of rulership is to combine a belief in one’s own infallibility with the Power to learn from past mistakes.

It need hardly be said that the subtlest practitioners of DOUBLETHINK are those who invented DOUBLETHINK and know that it is a vast system of mental cheating…This peculiar linking-together of opposites–knowledge with ignorance, cynicism with fanaticism–is one of the chief distinguishing marks of Oceanic society. The official ideology abounds with contradictions even when there is no practical reason for them. Thus, the Party rejects and vilifies every principle for which the Socialist movement originally stood, and it chooses to do this in the name of Socialism. It preaches a contempt for the working class unexampled for centuries past, and it dresses its members in a uniform which was at one time peculiar to manual workers and was adopted for that reason. It systematically undermines the solidarity of the family, and it calls its leader by a name which is a direct appeal to the sentiment of family loyalty. Even the names of the four Ministries by which we are governed exhibit a sort of impudence in their deliberate reversal of the facts. The Ministry of Peace concerns itself with war, the Ministry of Truth with lies, the Ministry of Love with torture and the Ministry of Plenty with starvation. These contradictions are not accidental, nor do they result from ordinary hypocrisy; they are deliberate exercises in DOUBLETHINK. For it is only by reconciling contradictions that power can be retained indefinitely. In no other way could the ancient cycle be broken. If human equality is to be for ever averted–if the High, as we have called them, are to keep their places permanently–then the prevailing mental condition must be controlled insanity.

“Populist” Donald Trump has clear contempt for the working class Americans who supported him—“I could stand in the middle of 5th Avenue and shoot somebody and I wouldn’t lose voters,” he memorably boasted last year—and his cabinet selection process seems to follow a Doublethink template: he chose an enemy of environmental protection to head the EPA, an opponent of contraception to head the family planning section of Health and Human Services, an opponent of public education to head the Department of Education, and someone who wanted to eliminate the Department of Energy to head the agency (although the agency was the one that Rick Perry couldn’t remember during his famous “oops” moment). Promising to drain the Washington swamp of donors and special interests, Trump has filled his cabinet with Goldman Sachs billionaires and multimillionaires.

So why shouldn’t Republicans reasonably conclude that Doublethink will allow them to claim they are lowering premiums and making healthcare more affordable when in fact their proposal (this according to the earlier CBO estimate) “would take more than $1 trillion away from programs targeting poor and middle-class families, to fund an $883 billion tax cut targeted at the wealthy.” As Vox puts it, this is “upward income redistribution of a truly massive scale.”

Trump may be retaining GOP loyalty at the moment because he appears to have found a magical way to bypass reality. So far, he has defied political gravity so why not see how far you can fly? As Krugman says of the healthcare effort,

This was a Freedom is Slavery, Ignorance is Strength moment. And it may be the shape of things to come.

If we let the GOP get away with this, they may be able to get away with anything.

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