Administrative State

To Be Puritanical or Pragmatic on Healthcare Reform?

- May 5th, 2017
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You’ve heard the spin coming from the Left and coming from some elements on the Right. The American Health Care Act (AHCA) is reviled by just about everyone. The Left hates it for the obvious partisan reasons and the Right hates it mainly out of an  understandable fear of being betrayed by our own Congressional leaders and their perceived weakness. To be sure, the bill that passed the House of Representatives left much to be desired. It is important, however, to keep in mind that the recalcitrant House Freedom Caucus ultimately voted for this bill. It cannot be all that bad.

I, for one, have never understood why we must repeal and replace an awful law, like the Affordable Care Act (ACA). In fact, I hate the entire idea of replacing Obamacare. Repeal and Replace was a talking point created by Republican strategists back in 2010 to get those much-ballyhooed moderates to swing their votes over to the Republicans. The logic was based on the flawed assumption that no American would ever support ending an entitlement. Many of us on the Right disagree with this bromide of conventional Beltway wisdom.

Yet we would all do well to remember that the bill that passed the House is not the final bill. Rest assured, it is during this iterative legislative process that our leaders will hammer out a much more workable bill. Now, I know what you’re thinking: that isn’t a good thing because it will give the politicians more time to equivocate and to hose We, the People.

What is likely at play is another classic Trump deal. In recent days, the Continuing Resolution now funding the government was extended until September of this year. The fear among the Congressional Republicans was that Trump would be intractable on the budget and a government shutdown would ensue. In the event that had occurred, Beltway Republicans argued that  the GOP would have been blamed for the shutdown and would have been at a disadvantage in the 2018 Midterms. Legislatively, Trump’s agenda would have ground to a halt. Whatever your opinion on this issue is, this is most assuredly what the Congressional GOP believed. Trump likely threw them a bone, giving them the budget that was least controversial—at least until September. In the meanwhile, he clears the legislative deck and allows the Republicans to focus on the prize: healthcare reform.

Whatever our problems may be with the House bill, we must remember that it rectifies the two big bugaboos the Right had with Obamacare: the GOP bill restores consumer choice and it lowers costs on the consumer. At the same time (and this is my problem with the bill), it purportedly appeals to those moderates—the great unwashed—who prefer to see a healthcare bill cover those pesky pre-existing conditions. What’s more, the House bill does this without the imposition of greater taxes on those who refuse to buy into the health insurance system.

This bill is not perfect. It may never be perfect. But, it is infinitely better than what the Democrats gave us. The goal here is to return as much freedom back as possible to the people. This bill already accomplishes that. And we have the ability to make it better.

Whatever does ultimately become law, Congress can tweak it later. But the core of what the Right has desired since Obamacare passed into law is protected. Freedom is the sine qua non of the United States. Choice and competition are essential components to maintaining freedom. Further, the removal of unnecessary and onerous taxes is vital for the preservation of America’s besieged middle class.

We are now moving the ball down the field and are heading toward the end zone. It is up to the GOP and the Trump Administration to make sure it’s a touchdown. In the ensuing days, it is up to every one of us to keep cheering them on to win this victory for us in the way we want it won.

As a former congressional staffer, I can tell you with certainty that elected officials listen to what their constituents say. Do not allow cynicism to get the better of you on this. Whatever pull lobbyists have (and they certainly do have pull); whatever other considerations our political leaders have, at the end of the day, most of them want to be loved by their voters. After all, if they don’t make a large enough group of their voters happy, they’re out of a job. And, believe me, most of our elected officials fear losing their jobs more than anything else.

So, call your senators. Call your congressmen. Call the White House. Send emails. Leave Facebook messages. Tweet your support for a bill that preserves choice, free market competition, and removes the need for more taxation. I guarantee you most of them will listen. It will at least move the needle in our direction. You can be sure that the Left will be doing the same on their end.

This healthcare repeal law is probably the biggest domestic policy issue facing us today. If the GOP cannot turn back the devouring leviathan that is the federal government; if Republicans cannot preserve choice and competition, while lowering taxes for the American people, then the country will be lost.

We could opt for the more obvious route of ideological puritanism. Honestly, I am very tempted to do this. We could throw our hands up and say that we’ve been hosed. Or, we can be pragmatic, and take the bitter with the better. We need to understand that we cannot have legislative victories on points of order for which we have not yet built popular support. We need to work on building that support and, as part of that, we should realize that nothing creates success like success. And, we need a win right now if we hope to persuade in the future. Trump’s legislative agenda needs some momentum. More important, we should see that this is not the end, but the beginning of an ongoing process to make American healthcare great again.

I’m not afraid of being partisan. I’m also willing to buck political orthodoxy (I was an early supporter of Trump, after all). However, I’m also willing to give people a chance—even our elected leaders. We’ve already gotten the core of what we wanted. Let’s not blow the whole thing up because there were some bad elements in there. We can work over time to make it better.

After all, the Left is just waiting for the GOP to self-destruct. Let’s not give them that opportunity. We can—and should—be pragmatic on this issue.


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