Monday, March 27, 2017

Is Healthcare Reform The Republicans' Waterloo?

There are two factors that Republicans seem unable to grasp as they seek to inflict their reverse Robin Hood agenda on America: (i) many GOP congressional seats are held because of gerrymandering, not because the GOP's policies are overwhelmingly popular, and (ii) Donald Trump won the presidency due to an Electoral College fluke - and the gutlessness of Electors - and overall won the vote of less than 30% of voters.  A third factor that may be also in play is the reality that a majority of Americans want the federal government involved in healthcare.  Indeed some pools suggest that a majority of Americans want a single payer system that would take away the power of health insurance companies that only care about making money and, frankly, do not give a damn abut taking cared their insureds or their insureds' best interest.  If the congressional Republicans had joined in passing Obamacare and been willing to take even more power from insurance companies and pharmaceutical companies, the nation would likely have a much improved and better perform healthcare system.  Instead, Republicans sold their souls to insurance companies and pharmaceutical companies and clung to the myth that the free market could improve coverage and reduce cost.  Anyone honest should concede that what the Republicans harp on even today is simply out of touch with objective reality.  Worse yet, a majority of Americans are catching on to the fact that the currently dead American Health Care Act was really all about give a trillion dollar tax break to corporations and the obscenely wealthy. . 

Conservative writer and columnist David Frum warned Republicans back when Obamacare was first being crafted that GOP obstruction and non-participation would haunt the party.  For his candor and insight, he was refarded by being figuratively ridden out of town on a rail by his Republican brethren. He's back again and once more suggests that healthcare and the public yearning for a well functioning national healthcare system will be the GOP's Waterloo.  He makes the case in a lengthy piece in The Atlantic.  It is a long piece, but worth the read and it shows what conservatism should be. Here are excerpts:
Seven years and three days ago, the House of Representatives grumblingly voted to approve the Senate’s version of the Affordable Care Act.  . . . . Rather than lose the whole thing, the House swallowed hard and accepted a bill that liberals regarded as a giveaway to insurance companies and other interest groups. The finished law proceeded to President Obama for signature on March 23, 2010.
A few minutes after the House vote, I wrote a short blog post for the website I edited in those days. The site had been founded early in 2009 to argue for a more modern and more moderate form of Republicanism. The timing could not have been worse. At precisely the moment we were urging the GOP to march in one direction, the great mass of conservatives and Republicans had turned on the double in the other, toward an ever more wild and even paranoid extremism. 
At that time, I worked at the American Enterprise Institute, the most high-toned of Washington’s conservative think tanks. . . . The mood then was that supporters and opponents of the Obama administration were engaged in a furious battle over whether the United States would remain a capitalist economy at all.
It was no moment for advocates of compromise—indeed, it was precisely because I appreciated its unwelcomeness where I worked that I had launched an independent blog in the first place. There, to the increasing irritation of my colleagues and employers, I fruitlessly argued through 2009 and 2010 that Republicans should do business with President Obama on health-care reform.
It seemed to me that Obama’s adoption of ideas developed at the Heritage Foundation in the early 1990s—and then enacted into state law in Massachusetts by Governor Mitt Romney—offered the best near-term hope to control the federal health-care spending that would otherwise devour the defense budget and force taxes upward. I suggested that universal coverage was a worthy goal, and one that would hugely relieve the anxieties of working-class and middle-class Americans who had suffered so much in the Great Recession. 
[W]hen the Democrats indeed did pass the law without Republican input, just as I’d warned they would, a fury overcame me. Eighteen months of being called a “sellout” will do that to a man, I suppose. I opened my computer and in less than half an hour pounded out the blogpost that would function, more or less, as my suicide note in the organized conservative world.
The post was called “Waterloo.” . . . . Even more provocatively to Republicans already fixed on a promise to repeal the Obamacare abomination, I urged: "No illusions please: This bill will not be repealed." . . . . The next morning came a phone call inviting me to talk things over with AEI’s president. By Thursday, I was an ex-think-tank staffer.
Over the next seven years, Republicans would vote again and again to repeal the Affordable Care Act. Total and permanent opposition to the law would become the absolute touchstone of Republican loyalty. . . . . From time to time, some old veteran would recall my 2010 prediction that the law would endure and smilingly wonder if I wished to reconsider.
I never did, for the reasons that the whole world has witnessed in real time over this week of Obamacare’s 7th anniversary.
Some of the conservatives who voted “no” to the House leadership’s version of repeal may yet imagine that they will have some other opportunity to void the law. They are again deluding themselves. . . . . Too many people benefit from the law—and the Republican alternatives thus far offer too little to compensate for the loss of those benefits.
In that third week in March in 2010, America committed itself for the first time to the principle of universal (or near universal) health-care coverage. That principle has had seven years to work its way into American life and into the public sense of right and wrong. It’s not yet unanimously accepted. But it’s accepted by enough voters—and especially by enough Republican voters—to render impossible the seven-year Republican vision of removing that coverage from those who have gained it under the Affordable Care Act. Paul Ryan still upholds the right of Americans to “choose” to go uninsured if they cannot afford to pay the cost of their insurance on their own. His country no longer agrees.
What happens now is that—a few bitter-enders aside—Republican politicians, especially in the states, begin the slow and belated process of entering the next era of health-care politics. . . . How generous should health coverage be? What should be done to control costs? Who should pay, and on what terms? To what extent should citizens be free to impose the cost of their unhealthy choices upon others? Conservative-minded people will converge on one set of intuitions; progressives on another. It’s possible to imagine a Republican health-care politics that rejects the ultra-redistributionary approach of the ACA and instead argues that since all benefit from health coverage, all must contribute to its costs via some kind of broad-based tax. 
It’s possible to imagine a Republican Party that cares about the details of health policy and is not satisfied with poorly informed hand waves toward outworn party shibboleths. It won’t happen soon, perhaps—but the sooner the better.
Health care may not be a human right, but the lack of universal health coverage in a wealthy democracy is a severe, unjustifiable, and unnecessary human wrong. As Americans lift this worry from their fellow citizens, they’ll discover that they have addressed some other important problems too. They’ll find that they have removed one of the most important barriers to entrepreneurship, because people with bright ideas will fear less to quit the jobs through which they get their health care. They’ll find they have improved the troubled lives of the white working class succumbing at earlier ages from preventable deaths of despair. They’ll find that they have equalized the life chances of Americans of different races. They’ll find that they have discouraged workplace discrimination against women, older Americans, the disabled, and other employees with higher expected health-care costs. They’ll find that their people become less alienated from a country that has overcome at last one of the least attractive manifestations of American exceptionalism—and joined the rest of the civilized world in ameliorating and alleviating our common human vulnerability to illness and pain.
I take no pride or pleasure in saying “I told you so.” . . . . Republicans who were wrong about the evolution of this debate please consider why they were wrong: Consider the destructive effect of ideological conformity, of ignorance of the experience of comparable countries, and of a conservative political culture that incentivizes intransigence, radicalism, and anger over prudence, moderation, and compassion.
Frum is 100% on target and the sooner sane Republicans get on board with what he suggests, the better. That may mean jettisoning the hate-filled Christofascists who rallied to Obamacare repeal, but that would be a very positive development for the GOP.

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