As supporters of the ACA, we aren’t always filtering Trump’s policy through a rose-colored lens; here is what Trump should do with the ACA.
In plain terms:
- Trump’s strong suit is “the Art of the Deal,” he is good at communicating, charming, and rallying support.
- The current Republican party is split as to what they want healthcare to look like, they have brought to the table a mishmash of good, bad, and ugly ideas that will please very few.
- From what I can tell talks have made it worse because it is one faction of GOP making deals with another one, neither is going to be happy, and this seems to be making the bill even less liberal and progressive friendly.
- One might think that either passing or not passing the AHCA will make Trump look good, but this is a catch 22; both will make him look bad as both result in negatives that people will feel and will call “TrumpCare.”
- Trump should respond to this catch-22 by giving states an opportunity to come up with a better plan. This will aggravate Ryan but will please others.
- In other words, Trump should turn healthcare into an episode of the apprentice, giving states and healthcare advocates a chance to submit ideas and plans. Then he can help choose a plan like he crowns a Miss America.
This tactic accomplishes a few things. 1. It removes the catch-22 and kicks the can down the road, and 2. It governs in-line with what people voted for (sure a fraction of the base voted him in on “lock-her up” and “build a wall,” but these far-right policies don’t play outside of that faction. The real base voted for “hope and change” and “not the establishment.” It’s as simple as that, ignore it at your peril.
By seeking good policy at a state level, healthcare becomes an opportunity for fresh non-establishment ideas and takes the heat off the current situation (which will end in disappointment no matter which direction it goes).
As far as I can tell, the only real workable option is single payer; the other option is a public option. The public option is increasing Medicaid expansion. All result in providers not getting “screwed over” by bureaucrats, which is what will happen with the AHCA’s removal of tens of millions (of Trump voters by the way).
Trump excels at reality TV and has made money in business; both of those areas of life are about working a deal out with parties.
Washington doesn’t work like that; the GOP wants to strong arm in a harmful policy.
This isn’t going to work out well for Trump. (I think Bannon even said this.) Don’t fall into the trap of thinking a deal can be made between factions of GOP that will somehow undo the healthcare that is already called TrumpCare.
Why not flip the script and give states like Indiana (with Pence’s HIP 2.0) a chance to bring a plan to the table?
Or even better, give the funding to the states and let them create their plans. Maybe we should drop central planning. I know we need central funding; that is how taxes work, but I think real dealmaking could be made through state implementation.
I know, states’ rights federalism, what a crazy notion. It doesn’t always have to be about taking away something; states’ rights also functions as a cooperative and competitive concept that cherishes those of our 320 million who aren’t Washington insiders.
Can we consider providing funding and giving flexibility to the states? It might work.
Icarus flew too high too fast, and while we still remember him today, the story was not about how “great” he was; it was about how he thought science, particularly physics, didn’t apply to him.