Reform instead of repeal and replace

By Steve Brawner
© 2017 by Steve Brawner Communications, Inc.

After the American Health Care Act failed in the House Friday, Speaker of the House Paul Ryan said this: “I don’t know what else to say other than Obamacare is the law of the land. It’s going to remain the law of the land until it’s replaced. We did not have quite the votes to replace this law, and so, yeah, we’re going to be living with Obamacare for the foreseeable future.”

For seven years, Ryan and other Republicans, including Arkansas’ congressional delegation, have said Obamacare is ruining the health care system – and by extension, the rest of the country. But once they gained control of everything in Washington, they obviously did not have a replacement ready, spent a total of 18 days debating a very bad one, held one vote and then announced their focus will now be on tax reform, though now they’re talking about revisiting health care again.

Because Republicans believe Obamacare is bad for the country but repealing and replacing it is very hard, why not try plan B – reform it? Members of Congress could do what once was done often with major legislation – reach across the aisle, compromise, and produce something that a majority coalition from both parties can support, even if some on both sides are unhappy. That would give shared ownership in the project and therefore less desire by one party to see it fail. Then, later, they could work to change it again.

Naive, I know. In today’s political environment, everything is about total victory and defeating the enemy, once known as “your fellow Americans.” Republicans know if they compromise with Democrats on health care, they’ll be scorned by conservative media sources and attacked by big money. Democrats are hoping the whole effort fails, knowing if it does, they get to be the majority again.

But not so long ago, Congress acted quickly and spent billions on a bipartisan basis to save the banking industry. We’ve been told by Republicans for years that Obamacare is a disaster already happening and a crisis in waiting. Maybe sooner rather than the “foreseeable future” is the best time to act.

“Obamacare” has always been a political term meant to fire up the political base, but solving a problem requires first defining it accurately, and Obamacare is not the root of the problem. Yes, the Affordable Care Act made significant changes to the health care system, but the system’s fundamental processes have remained the same. Profit-driven medical providers make more money when Americans are sick than when they are well, while insurance companies and government programs give Americans limited financial incentives to control the costs of their own health care. Meanwhile, the modern American lifestyle is simply too unhealthy to be cheap. We really can’t decide if we want a free market system or not. As a result of all this, health care was really expensive and didn’t insure everybody before Obamacare, and it’s really expensive and doesn’t insure everybody now.

Simply repealing and replacing one law isn’t enough to fix all that. The whole system – really, the culture – needs a reorientation, which the Republican leadership is clearly not ready to do if they can’t pass a single bill through one house of Congress. So if the status quo is unacceptable and radical change proves to be impossible, then the only alternative is incremental change the way the Constitution meant it to occur – through debate and compromise.

I’m not sure if congressional leaders even consider that possibility anymore. Ryan opened his press conference by saying, “Moving from an opposition party to a governing party comes with growing pains,” which would cause George Washington to roll over in his grave. The Constitution does not say anything about opposition parties or governing parties, or even mention parties at all. It’s as if we’ve become a British parliamentary system led by a prime minister and a king, rather than an American constitutional republic.

The system can’t work that way. Health care can’t be “fixed” by one piece of legislation, but it can be made better many small steps at a time. Let’s go back to the drawing board, give everybody a piece of chalk, and keep the eraser handy.

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