John Lydgate’s Wisdom Vis-A-Vis The AHCA

Most people probably have no idea who John Lydgate was, but most people probably have heard one of his famous quotes: “You can please some of the people all of the time, and you can please all of the people some of the time, but you can’t please all of the people all of the time” [Lydgate was a monk and poet in Bury, England (just North of Manchester) in the late 1300s and early 1400s].

I titled this post John Lydgate’s Wisdom Vis-A-Vis The AHCA because the above-mentioned quote of his is exactly why any law the GOP may be able to squeeze through under the Reconciliation procedure [required because there will be zero support from the 48 Democrats in the Senate] will ultimately fail just as the ACA [which was passed under Reconciliation with zero support from Republicans] is failing now. Whatever form it takes, there will be some “groups” of people who will not be pleased with it — people benefitting from expanded entitlements [Medicaid], people with pre-existing conditions who perceive [whether accurately or not] that their coverage is “less” than it “would have been” under the ACA, etc. The heavily-biased media will only need one case in each of these “groups” to plaster on every newspaper and TV screen images of doom “brought about by this terrible, mean-spirited law”, as practically all Democrats are calling it. Few if any media outlets will ever mention that comparing any new law — even one passed with bipartisan support — to “how things would have been under the ACA” is a meaningless exercise because the ACA in its current form is collapsing at a rapidly-accelerating pace, and it will continue to do so until all legislators in both parties are forced to work together to do something to fix the resulting disaster.

Mainly [but not solely] for this reason, I honestly believe that, from a long-term perspective, the best thing the GOP could do now is to simply back away and let the ACA finish collapsing. Let the Senate squabble a little more, and then schedule an Oval Office Message to the American People on Healthcare in which President Trump, with Senate Majority Leader Mitch McConnell and House Speaker Paul Ryan standing on either side of him [looking concerned, but frequently nodding approvingly], delivers a speech something like the following:

“My fellow Americans … As you know, a major promise I made to you throughout my campaign was to repeal and replace the Affordable Care Act — also known as “Obamacare” — which has been rapidly failing for the past several years and is now collapsing at an accelerating pace. Many of you also elected your current Senators and Representatives in large part because they made that same promise. I want to begin what I will say tonight with a simple truth: under the current procedural rules that govern the process by which proposed legislation makes its way through the Senate and the House and ultimately to my desk for signing into law, we cannot fulfill this promise at this time. That leaves us with no other choice but to move on to other important initiatives like tax reform, immigration reform, and developing a sustainable fiscal plan that will deal once for all with our mushrooming debt.

Removing Healthcare from our short- to intermediate-term focus will, unfortunately, allow the ACA, which was passed with no Republican support in 2009 and is still championed today by Democrats as a good plan, to continue in its downward spiral toward complete collapse. That will directly and adversely impact many of you who will continue to lose coverage and be left with few if any truly affordable options for replacing it.

The current two-party dominance in America, together with the extreme polarization that has developed for several decades along both ideological and fiscal lines, have resulted in the deadlock that we see now. The truth is that the filibuster, well-intentioned as it may originally have been, has become a mechanism that enables the minority party to block any legislative proposals it wants to block if they can achieve a monolithic, party-line mentality within their own party. Democrats have clearly chosen this path for the foreseeable future. I fully realize that Republicans were accused of the same mentality when they were in the minority not many years ago, but at least they weren’t completely monolithic in their thinking and would sometimes supply “defectors” to join with Democrats and get at least some things done. In fact, the whole reason we were unable to pass the current proposal in the Senate is that just a few Republican Senators were unwilling to move from their positions of opposition [which in turn were understandable based on the feelings of their particular constituencies].

In retrospect, all of this may actually be for the better when we look at the situation from a long-term perspective. All Democrats refuse to discuss any bill that is characterized as repealing the ACA, and some Republicans refuse to discuss any bill that isn’t characterized as repealing the ACA — even though they all know that the ACA cannot survive without considerable modification that would be very close to “repeal and replace”.

When the ACA collapses beyond a certain point — a point that is difficult to accurately describe or predict, but which is much nearer than anybody in our leadership would hope — bipartisan development of a solution will become not only desired but necessary because the situation will be the very crisis we have been sounding alarms about for the entire eight years since the ACA became law. At that time, I can assure you that I will have no higher priority than to turn that crisis into an environment in which as many of you as possible will have the best healthcare possible within reasonable fiscal bounds. There isn’t a doubt in my mind that Senators and Representatives in both parties will be eager to work with me toward that end — Republicans because they will finally be able to achieve more of what their constituents elected them to do, and Democrats because they will then still own a system that has actually collapsed [i.e., they will no longer be able to argue that the ACA is not fundamentally flawed, and that trying to patch it with improvements is a better option than learning from its failure and developing a better plan that is not encumbered by elements retained from a failed system].

It is important to me that you know what a huge disappointment this is for me. I wanted very much to deliver on this promise very early in my administration. But it is what it is, and we have too many other priorities that have been waiting too long. As of tomorrow, we are moving on to those priorities.

I want to thank you for making me your President, and for providing what theoretically should have been a Legislative environment in which I could have moved forward quickly with the agenda I laid out in broad terms during my campaign — that environment being majorities in both the Senate and the House of Representatives. I look forward to getting back to Healthcare at an accelerated pace as soon as failure of the ACA reaches the point I’ve mentioned tonight that will make that possible.

Thank you for listening to this message that is directly from my heart. May God bless you, and may God bless the United States of America.”

It will be most interesting to see whether the Senate brings a bill to the floor [knowing it may not pass], and if so whether or not it passes. In that situation, it will be even more interesting to see if a Senate-House compromise bill can be passed and sent to the President for signing. And in that situation, it will be even far more interesting to see if the President considers vetoing it [unheard of as it may sound, I honestly believe that is a possibility — see some of my earlier posts, and the related pages at this site]. Fasten your seat belts for the ride — it might be bumpy!