Republican health care: Dead on arrival

April 2017 Health 2

By JOE AUCIELLO

In an early test for the Trump administration, the pledge to “repeal and replace Obamacare” was developed into a legislative proposal that was withdrawn before its anticipated defeat in Congress. The full support of the president and a major push by Speaker of the House Paul Ryan came to nothing.

The failure also highlighted the lack of competence in a president who has touted his business acumen and negotiating skills. Despite, persuasion, pressure, and ultimatums, President Trump could not generate enough support within his own party to do what the opponents of Obamacare have been vowing to do since the Affordable Care Act was first adopted in 2010.

This dead-end legislation resulted from factional warfare within the GOP. Republicans have begun governing by the proverbial circular firing squad. To draft a new health-care bill, they aimed assault rifles at each other and began blasting away, with predictable results. As his fatally wounded plan lay dying, President Trump chose to blame the Democrats.

For a bill to have been approved in Congress, party and faction compromise would have been necessary, but, despite concessions to both Republican groupings, the pieces could not be made to fit. No coalition formed, not even a temporary one.

Democrats would have no part of the Republican plan. The GOP centrists or moderates were too few. The 30 to 40-member hard-right House Freedom Caucus would not budge from its demands, even with the result of preserving Obamacare. This group, like all the others, was too small to pass a bill but large enough to block one. Stalemate meant failure.

A political leader once said, “The art of politics consists in knowing what to do next.” By that measure, the president who loudly claims to have mastered the art of the deal has clearly not mastered the art of politics.

That Americans deserve and need better than what Obamacare has offered is hardly in doubt. That President Trump and his business buddies will provide better is definitely in doubt. In fact, it is becoming increasingly clear that any Republican-replacement plan will certainly provide less coverage to fewer people at higher cost—and with higher corporate profits—despite claims to the contrary from GOP leaders.

All of the health-care plans and proposals emanating from the Washington-Wall Street nexus, from ACA/Obamacare to the eventual Republican plan, suffer from the same fatal flaw. They are all intended, in the first place, to create exorbitant corporate profits, and, in the second place, to provide some measure of “good medicine.” These two goals—money and health—are inevitably in conflict.

Capitalist America places the greater value on the health of business rather than on the health of people. The latter is simply a byproduct of the former.

Despite the recent debacle, battles over quality health care are far from concluded. Before facing voters again, Republicans will have to try to make good on their promises. Eventually, Republican Healthcare 2.0 will be released to Congress—that is, another bill that takes away from the poorest, the oldest, the neediest, and gives to the wealthiest. At this point, though, Republicans are still reeling from their defeat: no future plans or timelines have been announced.

Americans will need to see through the right-wing fog of rhetoric in order to go beyond the Republican plan, beyond Obamacare, and towards a universal health-care program with access for all. Until then, Obamacare, a flawed system whose insurance costs are still too high for too many, remains in place.

What should be on the public agenda now is a serious discussion about proposals for national health-care and single-payer plans. This sentiment was brought forward repeatedly in speeches and interviews at the annual convention of Students for a National Health Program, meeting in March in Philadelphia. Matthew Moy, a fellow at the American Medical Student Association, told the Philadelphia Inquirer at the gathering, “When you believe that health care is a human right, the only way to adequately and efficiently provide for everybody is through a single-payer system, which won’t waste money with a middleman insurance company telling you where you need to go.”

AP photo: Health-care protest in Los Angeles.