One of the most fascinating concepts in politics is the concept of gaps. It is a difficult concept to put into words, but it is a natural phenomenon that occurs in any number of areas. Essentially, there is a gap between perception and reality. Occasionally, there is a gap between how people feel about something depending on what it is called. If you simply describe the Affordable Care Act you’ll find that the individual planks that make up the law get very high approval ratings. Usually, the law itself gets solid marks for favorability if you use the specific label of the ACA. If you call it Obamacare then it suddenly tanks. We’ve seen this for years. It isn’t a new thing.

There are countless examples of people screaming “keep the government out of my Medicare!” Either way, the favorability for the ACA is at nearly 60 percent presently. Yet, many of those same people are screaming at their representative to repeal Obamacare and replace it with something better. We can dwell on this and I could be mean here, but we will just leave that here as an example of what we are talking about.

Liberals, progressives, and leftists have been dealing with this for years. The greatest example would be the scourge that is socialism. Most people would tell you they hate socialism and think that everything evil is socialism. Yet, when you break it down brick by brick you suddenly find that they support the individual aims that many socialists support. Even when we aren’t talking about socialism itself, the challenge is fighting against the overwhelming perception of what we (whatever you want to call all of those groups collectively) support. For one, we* are not the same. We do not support the same things no matter how often right leaning politicians want to paint us that way.

The challenge for the Democratic party in general and for each of those groups specifically is to find a way to convert people’s approval of the ideas into approval of the platform in general. If you support a majority of the aims within the platform then you support the platform. That seems overly simplistic, but sometimes we need to make things simple.

All politicians label their opponents. It is blood sport in Washington and at the statehouse. Yet, conservatives have been better at it. Somehow a collection of common sense suggestions have become socialism. Socialism has somehow become a Venezuelan hell scape where everyone goes hungry and all of your freedoms get suspended. Most of Western Europe is socialist. The only thing happening there is that people have a robust safety net. Their college education is paid for. Their health care bills are taken care of. They get help with family leave. Their retirement benefits are better. It sounds like hell on earth.

I am not an expert on messaging and that sort of thing. Maybe I could have become a speech writer if I had gone another direction in graduate school. What I know is that we got here through a very targeted and purposeful campaign by conservatives and right wing media. They played the long game. I know that people left of center tend to look at these faulty perceptions and assume that the folks are just stupid. We have to start the slow and painful process of repeating the truth over and over again. Maybe people will start waking up and supporting the things they actually say they support.

Paul Ryan was on Face the Nation yesterday morning talking about the Republicans’ new anti healthcare bill they’re trying to sell to the American people.  Host John Dickerson tried numerous times to get Ryan to acknowledge that millions will lose their healthcare and that all major medical associations are opposing the measure.  Ryan engaged in his now familiar obfuscation with a big smile, repeating this most often used mantra of giving people “choice” and fostering “competition” in health care delivery.

Here’s the problem with the Republicans’ key economic assumption in their ideology.  Choice and competition come from a functioning free market.  You can call our healthcare delivery system in the US a lot of things, but “free market” is not one of them.  Here’s why:

Over 30 years ago, Michael Porter of the Harvard Business School developed a model to describe markets.  In his model, he describes 5 essential forces that control markets.  To be a fully functioning market, the power of buyers must be in parity with the power of the sellers.  At the same time, buyers must have alternatives from existing competitors, and those competitors must be continually under threat from new entrants into the market as well as new products or services that can substitute for the product already being sold.  An example: You want a car; you have numerous choices between new and used, expensive or thrifty.  You can buy online, you can buy from individuals, you can buy from numerous dealers.  You can check prices online, making the market relatively transparent.  As well, you can choose when you buy that car.  Or you can buy a motorcycle.  Or you can not buy a car and take Uber.  This market balance represents a relatively free market, subject to truth in advertising and financing laws.

Now, let’s look at our healthcare markets: Sellers (insurance companies and healthcare providers) dictate coverage and pricing.  The polices are intentionally complex and pricing is completely opaque.  In most Americans’ cases, EMPLOYERS pick which plan their employees can buy.  In this market, the sellers hold all the power and the buyers have only the choices that are dictated.  Additionally, the insurance markets are protected by state agencies, making it very difficult for alternatives to get into the market.  To make matters worse, when you’re sick, the LAST thing you have time or the inclination to do is price shop for healthcare.  Removing the market protections the ACA provides puts individual buyers at  the mercy of this cruel government protected market.  Republicans are trying to jam free market ideology into a market that is anything but free.  The cabal of insurance companies and healthcare delivery companies is impossible to to fight, especially by individuals.

So, with these clear market realities that make the Republican plan unfair and unworkable, what does that say about Paul Ryan’s argument for his plan?  There are two possible answers: 1) Ryan is stupid with no understanding of the realities of markets; or 2) He’s a lying sack of sh*t (sorry Momma) who is looking out for his base and the interests of his largest donors to the detriment of everyday Americans like you and me.

I’ll take Door Number Two, Alex.