After the humiliating debacle in which Paul Ryan and Donald Trump had to pull their health care bill from the floor or see it go down in flames, the talk was that the reform effort was dead, at least for some time, and that Trump and Ryan would reluctantly defer health care actions that hurt the poor and middle class and instead move on to other things dear to their hearts that hurt the poor and middle class, like cutting taxes on the wealthy.
But suddenly, talk of a new health care bill emerged. It wasn’t clear if this was a serious effort or just a smokescreen put up by the Republican party to try to convince their supporters that they were still going to repeal Obamacare and thus erase the image of failure. Trump even threatened to work with Democrats to craft a new bill if the Republicans would not cooperate with him. This threat was empty in that Democrats were unlikely to sign on to anything that took away key features of Obamacare the way that Republicans want and those Republicans who opposed the first effort knew that..
The attempt to forge a compromise seemed to become more real when vice-president Mike Pence was sent to Congress on Wednesday night to meet with those Republicans who torpedoed the first effort to see if an agreement could be reached with them. But even before the talks could begin, reports emerged of it unraveling and the talks ended up with no deal being reached, and the various parties as usual blaming others for the failure.
Chris Collins, a moderate Trump ally from New York, said resignedly that the ball was in the court of the Freedom Caucus, a coalition of arch-conservative legislators who didn’t support the initial Republican healthcare proposal. “We built them a bridge,” said Collins. “All they have to do is walk across.” He added, simply: “The problem is with the Freedom Caucus.”
To Collins, this faction within the House GOP had been not been straightforward in negotiating over healthcare in recent days. “Indications … were on Monday that they wanted to get to yes,” said Collins. “Actions speak louder than words and over the past few days, actions would indicate that those words would not have been sincere.”
In his opinion, the Freedom Caucus kept on “moving the goal posts”.
Conservatives returned fire. Mo Brooks of Alabama, a member of the Freedom Caucus, noted that House Republicans had voted to totally replace the ACA in 2015 and reluctance to do anything less than that represented a flip-flop. In Brooks’s opinion, those who wanted to preserve parts of the ACA had “not only moved the goalposts, they’ve taken out the stadium, chopped ’em up and burned them”.
On Wednesday, conservative groups lashed out at moderate Republicans, blaming them for derailing the latest attempt to repeal and replace the Affordable Care Act.
Dan Holler, the vice-president of Heritage Action, said conservatives had already “ceded a lot of ground” on fully repealing the healthcare law.
What bugs me about this reporting is this talk of ‘moderate’ Republicans. There is no such species. What the Republican party consists of are extremists and ultra-extremists and calling the former moderates is utterly misleading.
One thing that I found interesting is this column titled The road to single payer health care by Charles Krauthammer, someone who is a reliable hardline conservative and neoconservative. First he predictably makes the silly right–wing argument that we should be able to pick and choose what health needs we want to cover.
Even more significant would be stripping out the heavy-handed Obamacare coverage mandate that dictates what specific medical benefits must be included in every insurance policy in the country, regardless of the purchaser’s desires or needs.
Best to mandate nothing. Let the customer decide. A 60-year-old couple doesn’t need maternity coverage. Why should they be forced to pay for it? And I don’t know about you, but I don’t need lactation services.
Ha, ha! Good one, Charlie! But why stop there? Why not go further? Why should those who do not have cancer pay for the expensive chemotherapy, radiation, and surgical treatments of those who do?
Of course, being able to pick and choose only what we need goes against the entire concept of what makes insurance affordable, by spreading the costs and risks over a large population of sick and healthy alike. Eliminate that, and what you have is each person being stuck with the costs of their own treatment, which is fine if you are rich. And that is, of course, the point, the dream of Republicans.
But he then argues goes on to reveal what really scares him, that what we might be seeing is the first stage on the road to creating a government-run single-payer system, the thing that most developed countries have and that Republicans hate the most because it would provide free health care to those who are not wealthy. It is worth quoting him at length.
But there is an ideological consideration that could ultimately determine the fate of any Obamacare replacement. Obamacare may turn out to be unworkable, indeed doomed, but it is having a profound effect on the zeitgeist: It is universalizing the idea of universal coverage.
Acceptance of its major premise — that no one be denied health care — is more widespread than ever. Even House Speaker Paul Ryan avers that “our goal is to give every American access to quality, affordable health care,” making universality an essential premise of his own reform. And look at how sensitive and defensive Republicans have been about the possibility of people losing coverage in any Obamacare repeal.
A broad national consensus is developing that health care is indeed a right [My emphasis-MS]. This is historically new. And it carries immense implications for the future. It suggests that we may be heading inexorably to a government-run, single-payer system. It’s what Barack Obama once admitted he would have preferred but didn’t think the country was ready for. It may be ready now.
As Obamacare continues to unravel, it won’t take much for Democrats to abandon that Rube Goldberg wreckage and go for the simplicity and the universality of Medicare-for-all. Republicans will have one last chance to try to persuade the country to remain with a market-based system, preferably one encompassing all the provisions that, for procedural reasons, had been left out of their latest proposal.
Don’t be surprised, however, if, in the end, single-payer wins out. Indeed, I wouldn’t be terribly surprised if Donald Trump, reading the zeitgeist, pulls the greatest 180 since Disraeli “dished the Whigs” in 1867 (by radically expanding the franchise) and joins the single-payer side.
Talk about disruption? About kicking over the furniture? That would be an American Krakatoa.
While Krauthammer views this prospect with gloom, I for one would be delighted. I have long supported a single payer system and Bernie Sanders’s proposal of expanding Medicare to cover all would be the simplest way of getting there.
So for the first, and perhaps the only, time, I sincerely hope that Krauthammer is right.