This Healthcare Thing is Going Just Like You and I Thought

I don’t really care who you blame or credit for the Obamacare debacle last Friday.

Because I think we are now a step closer—possibly—to repealing O-care.

President Trump is a Republican by convenience, a Democrat by history and geography, and a deal-making artist, by his own description.

He faces a divided Washington: Ryan/GOP establishment vs. conservatives vs. Democrats, whose blind faith in the Affordable Care Act would be the envy of many a religion.

Trump knows he will have to lead the solution for the imploding ACA, but first he had to go through the proper protocols, so he deferred to the GOP leadership—you know, the people who tried to throw him off their ticket last year.

They’ve bragged about how they could slay the Obamacare dragon, and he probably knew or suspected they weren’t ready to do it. Which they weren’t.

But he had to let them fail, and fail they did.

Pulling that bill was the only thing they did right with it.

Next up: the conservatives, like the House Freedom Caucus (isn’t it sad that “freedom” isn’t a caucus they would ALL belong to?), and ultimately the Democrats.

The Freedom folks will mean well but also fall short, by scaring people who have insurance into thinking they will lose it, which will leave…the Democrats. And yes, Donald Trump will work with some of them. He knows how he won Michigan, Wisconsin and Pennsylvania last fall. He’d like to win them again.

I don’t know exactly what this “deal” will look like.

Would that it could be something simple, basic, and freedom-ier: more emphasis on catastrophic policies, more state flexibility and more incentive for consumers of healthcare to compare and economize. Just guessing.

Democrats will join him either because they come from states where he won, as will some Republicans. Or Democrats will think Trumpcare will get us closer to universal health care. It’ll be strange bedfellows, as they say.

A lot of the heavy lifting of the modern presidency is working the factions of the moment, and finding common ground from issue to issue. JFK had vastly different Capitol Hill allies on his domestic agenda versus his foreign policy forays. You could scarcely tell the D’s from the R’s. Reagan accomplished as much with Tip O’Neill as he did with the leadership team of his own party.

A president sets a broad pragmatic vision and finds the path for getting there.

You might call it the “art of the deal”.



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