I was never sure whether this was Paul Ryan's health care bill or Donald Trump's. They both had a lot riding on its success. But they both lost -- because it is such a lousy deal.
Let's face it. Health care insurance is a tough thing to work out; and replacing Obamacare is nearly impossible, because various political ideologies oppose it for different reasons. Nothing short of Medicare for All type of single payer plan is going to beat the Affordable ObamaCare Act.
You try to make one thing better, and it sets something else off. The only way to really lower costs without reducing benefits or increasing the number of uninsured people is to go after the administrative costs and the profits made by insurance and pharmaceutical companies.
Here's the solution. Republicans, just accept defeat on this. It's impossible enough, and then you tried to add in a huge tax cut for the wealthy. No way. The American people see through what you tried to put over on them, and they don't want it now that they finally know the score. Now that they finally know you've been lying to them.
And then you have to put Democrats back in control, join all the other advanced countries in the world, and provide health care for everyone paid for through a tax system.
Everybody will come out better -- except those profit-making corporations and their lobbyists. We'll still need someone to manage the system and to make the drugs. And, frankly, lobbyists probably have enough salted away to live on quite comfortably. If not, then it's their turn to hurt a little.
There is no other way. A market based insurance system for everyone just does not work; because insurance companies demand a profit, so they try to screen out people who will be high risks -- or else raise the rates so high it's unaffordable.
That's what I think. Now for a little wisdom from Howard Fineman, who wrote that Donald Trump needs to realize that Washington is not Manhattan, and closing a deal by "bullying people or buying them off with borrowed cash" is not the way to win battles when you're president. He continued:
"Your job is to find consensus, cajole others into thinking that your vision is theirs. Projects get 'built' here more with rewards than threats. It is not a brutal game of 'the last man standing.' It's 'we're all in this together,' even when the 'we' is just your own party."
Fineman then quoted the late Harvard professor Richard Neustadt, who wrote that "presidents must be careful, anticipatory; they must listen, adapt, and be collegial, not dictatorial."
To say the least, that will not come easily for this president. It's doubtful that he can do that, even if he wanted to try.
Ralph
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