008 – Improve the ACA, rather than just trash it? What a concept. Who knew? (An Editorial)

Uhh, actually LOTS of people knew … and still know.

The initial failure of the McConnell led Republican Senate to pass their version of wealthcare, may finally lead to an opportunity which might be a whole lot bigger than just the American healthcare system.  Now, to be sure, wealthcare is not dead by any means.  We saw the Ryan led Republican House fail the first time and then narrowly pass their version on the second try after a bunch of arm twisting.  McConnell will do everything he can to try and get their version through as well.  At least, his colleagues now have the 4th of July recess to think about it … and to hear about it from lots of their constituents.

There has seldom been much positive coming out of Washington ever since the Donald blocked out the sun.  But just since the vote was postponed, there are a number of new voices on the Republican side saying things like, “You know, maybe we are better off actually trying to work with the Democrats to try and improve upon the system we have.”  Repeal, without a replace, regardless of what their slogan says, is not a workable concept.

Look at some of the voices we are now hearing from on the Republican side – Lisa Murkowski from Alaska, Susan Collins from Maine, Dean Heller from Nevada and even John McCain and Lindsay Graham.  It is finally dawning on all of them that repeal without a replace is NOT what the vast majority of the American people want.

The voices on the far edges of both parties will need to be marginalized in order to go forward.  Rand Paul and the Freedom Caucus will likely never accept any type of compromise.  Any compromise will likely have to include the elimination of the removal of the tax that funds a large part of the ACA, and inclusion of funds for Planned Parenthood will likely need to be part of that compromise as well.  There’s no way Paul and his group will ever go for that.

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Unfortunately, I believe the same is likely true of the extreme Progressive end of the Democratic party.  It has been great to see the enthusiasm generated by Bernie supporters.  But what I see now is that they seem to just smell blood in the water and that they think now is the opportunity to just push through the extremely progressive end of their agenda, such as single payer healthcare or even Medicare for All.  If they hardline those ideas right now, then they are very little better than the extreme voices on the Republican side trying to ram through wealthcare.

There are lessons to be learned from the last few months.  The first is that after 6 plus years of the ACA, the positives of that system have become something that people rightly do not want to see go away.  To achieve those positives, you need revenue and the tax on the wealthy is part of that solution – not the whole part, but certainly an integral part.  As I mentioned in my previous editorial, it’s not like our economy has tanked or that jobs have stopped being created because of the taxes that were imposed as part of the ACA in 2010.  Just the opposite has occurred.  That tax increase has, not surprisingly, been absorbed quite nicely.  But it likely will not be enough to either sustain or significantly improve the ACA, which is what needs to be done.

The second lesson we certainly should have learned is that anything having such major impact on the daily lives of our citizens cannot just be rammed down our throats by whichever party happens to be in power at any given time.  We cannot afford to play ping-pong with healthcare, nor with any other major legislation.  That is exactly what would happen if the Democrats gain the majority and then are able to push through universal healthcare without any Republican support.  The rancor would continue and then, when inevitably Republicans once again gain control, they would restart this same process all over again.

Each side has to have an iron in the fire … some skin in the game.  Use whatever trite idiom you need to describe it, but each side needs to feel that they are fighting together FOR something, rather than simply fighting against the other side.

That opportunity seems to have at least a chance of becoming a reality.  One of the best indicators of that opportunity is actually the person currently in the White House.  I certainly have not said there is much if anything positive that has come, or is likely to come, from his Presidency.  But at least in this regard, Congress can turn one of Trump’s biggest negatives into a positive.

The Donald, if you haven’t figured it out by now, is probably the least ideological person to ever hold that office.  Said another less charitable, but equally descriptive way, he is the least principled person to ever hold that office.  In regard to having Congress finally be able to work together, that can be used to everyone’s advantage.  The Donald only wants to win.  If the majority agreed to universal healthcare, then he would be right on board.  If the majority just wanted to defund healthcare entirely with no replacement, he would back that equally as enthusiastically.  If the majority realizes that it needs to meet somewhere in between, the Donald will support that to.  Anything goes just so that he can simply claim a win.  Do you honestly believe that same opportunity would present itself with Mike Pence at the top?

The truth is that the majority, at least for the foreseeable future, will NEVER agree to universal healthcare.  We are certainly not there yet, and there is no guarantee that we will be anytime in the near future.  Equally as true, which the Republicans are finding out, is that the majority will NEVER agree to simply ceding the obvious gains that have been experienced with the passing of the ACA.

The answer lies in between – in improving upon the ACA in those areas where it most definitely needs improvement and in each side compromising on some of their most extremely held core beliefs.  If that could be done with healthcare, then just maybe, just maybe, our representatives on both sides would see that it is a workable path on other issues as well.

The continuing theme of my editorials has been to try and find those “silver linings” in the chaos, the division, and the frustration that have been hallmarks of our political process – particularly since the election of Trump.  This would be a huge (to borrow a term) silver lining … if only it would come to pass.

008 - 7 years of practice

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