Obamacare(s), Trump doesn't

UPDATE: The Republican Party is in control of the White House, the Senate, and the House of Representatives, yet it could not pass the "repeal and replace" of Obamacare they've been promising for 7 years. House speaker Paul Ryan pulled the proposed legislation from the floor Friday afternoon, when it became apparent the GOP was too divided to pass it.

That is not a bad thing, for Obamacare needs fixing, not repealing.

But Donald Trump reacted in a way that shows he really does not care about the fate of medical care for millions of Americans. He immediately said the Democrats (who were sidelined during the process) are the culprits for his inability to close the deal, and for the massive defeat of his most heralded campaign promise - "I will repeal and replace disastrous Obamacare  immediately" on "day one". So much for that.

The clincher though was his assertion that he will let Obamacare collapse, to make the Democrats come begging for a deal on health care. That he would lets millions suffer to score a political point is bad enough. Worse yet is that Trump promised that Obamacare "will explode", and signed an executive order designed to impede Obamacare and make sure it doesn't work. That's an indefensible thing for a President to say, much less do.

(the original March 23rd post follows)

Let's be clear. Republicans oppose Obamacare not because it is bad but because it was championed by President Obama. After setting out to make him a "one term President", they voted 60 times to repeal Obamacare but never bothered to craft a valid and viable alternative.

Regardless of whether or not Republicans and Donald Trump pass what they refer to as "Obamacare repeal and replace", it's clear who their victims are: the American people. Their repeal does not replace, and Trump-RyanCare will kick millions of Americans out of affordable medical care.

When they realized their "repeal" would leave 24 million American uninsured, some balked. What are they to do? Repeal, because they promised to do it, and leave millions of Americans with no medical care and be blamed for that; or... keep most of Obamacare and current benefits to millions of people and be blamed for breaking the repeal promise. Either one is a tough choice. They walked themselves right between a rock and a hard place.

Part of the problem stems from Trump's hurried inexperience and his promises to repeal Obamacare immediately after being sworn in. You cannot, without consequence, immediately undo a bill negotiated over two years.

On top of it all, while on the campaign trail, Trump promised, according to a Politico roundup to "repeal and replace" Obamacare while keeping the basis tenets of... Obamacare:

- Insurance for all: "I am going to take care of everybody … Everybody’s going to be taken care of much better than they’re taken care of now.”

- Affordable insurance: “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.”

- No cuts: “I was the first & only potential GOP candidate to state there will be no cuts to Social Security, Medicare & Medicaid”.

- Keep your insurance: “We don't want anyone who currently has insurance to not have insurance.”

What Donald Trump, who has not the faintest idea of what policies and legislation are, and the Republicans are promoting right now is a complete disaster that will take back of all of his promises. It shows he was lying on the campaign trail and will now betray those who voted for him. You can't promise everything and its opposite and get away with it.

In order to bring the radical tea party (or Freedom Caucus) Republicans along, the leadership is prepared to kill many essential features of Obamacare. Yes, the following would no longer be available with all insurance plans:

- Emergency services

- Hospitalization

- Pregnancy, maternity, and newborn care

- Chronic disease management

- Pediatric services, including oral and vision care for children

How does that square with Trump's campaign promises? The pick-and-chose policies will make premiums go up sharply for women, older, and sicker people - insurance companies will make a fortune, selling cheap policies to people who don't go to the doctor very often, and another fortune selling prohibitively expensive policies to women with children (and their husbands), and anyone who needs any type of substancial medical care. In sum, the premiums will go down because they cover almost nothing. If you need real world coverage, it will cost you. If you are a sick or older American, the Congressional Budget Office estimates your current coverage may cost you 400% more.

To justify the inequality, Tea Party-Freedom Caucus Republicans, supported by Trump (who has met with, and tried to appease, them) are asking: Why should a single man looking for insurance have to purchase a plan that also offers maternity care? Well, let's take the argument further and ask: why should a woman purchase a plan that offers prostate cancer care? 

Do we really want to go there? Clearly not.

There would be a third choice. Republicans and Trump could stop this contest to see who can make health care worse, apologize and keep and fix Obamacare, so that millions of Americans would have continued access to affordable medical care. Instead they feed the American people unworkable ideological statements and show no qualms about ruining the lives of millions of their fellow Americans. If they continue to go down this route, Republicans will pay for it at the congressional elections next year.

As for Trump, I will paraphrase John Harwood, "If you start health care debate at 'take care of everybody' and pass a bill by deleting essential health benefits, are you a master negotiator?"

Radical Republicanism

The Republican party has disappeared. It has been replaced with Radical Republicanism.
To be sure, the GOP has been slowly withering away but the process became more noticeable in 2008, when presidential candidate Sen. John McCain selected Sarah Palin as his running mate.

That historically ill advised and catastrophic choice heralded the promotion of ignorance as a means of political advancement. Years later, GOP presidential primary candidate Rick Santorum would accuse Barack Obama of "elitist snobbery" and "hubris" for promoting higher education.

On the backs of people like Palin, the Tea Party radicals took over Congress with a simplistic, uninformed message: government is wrong. All government. No compromise.

Nevertheless, they thrived.

They changed the GOP. More, they kicked John Boehner out and became the GOP.
The "small government" party is now the "anti-government" party. It came in with a clear plan: paralyze government, make sure it doesn’t work. Then turn around and say ‘See, I told you government doesn’t work’. It worked.

The GOP was not able to defeat Barack Obama at the polls, but opposed him at every step of the way, every initiative large and small. Governing the country was no longer the goal. Opposing Obama became their only defining and uniting characteristic. They successfully paralyzed government, blamed Obama, and wildly took over in 2016.

To the establishment Tea-publicans chagrin, those tactics enabled Donald Trump, not one of their own, but for now they're allies. The idea that being ignorant and against everything was a viable path to power proved itself right.

So, we are now in the hands of radical Republicans and a intellectually null President who have no idea what governing is. They only know how to rail against things, be it Obamacare or the immigrants. Their solutions solve nothing and screw most. Once the poor lower middle class that voted them in gets tired of being screwed over, these heralds of radical Republicanism will be kicked out. Until then, brace yourself for a nasty, scary ride.