Health Care Will Be Revisited

Last week when the House failed to repeal and replace Obama care I stated that perhaps eventually the adults in the room might consider working together and craft some bipartisan legislation. I decried when the Democrats passed ObamaCare on a strictly partisan vote. I happen to believe that any legislation that impacts a major part of the American public’s life should be negotiated with both sides and a compromise reached that brings bipartisan support to the legislation. I still firmly believe this.

In the aftermath of the failure in the House a lot of blame was thrown around and finger pointing became the game of the day. I pointed out that public opinion polls showed the American public did not like the bill be put forward by the House leadership and perhaps those on the right within the party actually did everyone a favor to forcing them to withdraw the bill.   This led to a round of grinning and clapping by liberal Democrats who claimed the American people had been saved from the evil Republicans. In truth even the most ardent supporter of ObamaCare knows that the health program has major problems and needs to be overhauled or it will collapse of its own weight. Simply put, the program is not sustainable because the Democrats front loaded the legislation with all the good parts and put all the negative stuff in the backend. Well, the backend is coming and President Obama knew he would be out of office by then and it would be someone else’s problem.

There are some good things in the Affordable Care Act (ACA) just as there were some good things in the American Health Care Act (AHCA). The problems were in the details with both bills. The major problem for Republicans is that once you give the American public something that a lot of them will get for either free or highly subsidized they are not willing to give that up. The problem for the Democrats was the rising cost of premiums and deductibles was forcing many to either abandon buying health care or demand that it be repealed. It is the old winners and losers equation that occurs with any major piece of legislation.

So now that the dust has settled President Trump is beginning to learn that you cannot just demand that things be done. That might work in the business world where you are the ultimate boss but in the political world it requires a little more finesse. It was that same hubris that was exhibited in President Obama over and over and ultimately prevented him from passing any major legislation once the voters ousted the Democrats in the aftermath of passing the ACA. When they passed it they had a 60-vote majority in the Senate (filibuster proof) and a strong majority in the House of Representatives. After the next election they no longer had that 60-vote edge in the Senate and they were in the minority in the House.

Today there are reports that President Trump is willing to reach out and work with Democrats to forge some sort of alliance between moderate Democrats and Republicans and carve out a majority to pass bipartisan legislation. If this in fact correct I salute the President for making a major pivot. Ronald Reagan did this in negotiating with then Speaker of the House Tip O’Neil (D-MA) to achieve tax reform and some other victories. Bill Clinton did this when he lost majorities in Congress and passed Welfare Reform and other legislation. I have always maintained the mark of a good leader is one that can realize their own strengths and weaknesses and work with the opposition to achieve common goals.

The Administration and Congress will now move to tax reform as the next major goal but do not think they will abandon healthcare. They cannot afford to simply ignore the problems in ACA because they will not go away. The losers in that program will continue to be hurt and eventually many of the winners will find the gains they liked beginning to evaporate. The political leadership in this country will have to come back to healthcare and to address it in a bipartisan way that can help to correct the problems.

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