Amid all the talk over the years from Republicans and their new leader, we know full well that they want to repeal the Affordable Care Act, and we've been promised from them even better and less-expensive coverage to replace it. Just yesterday, in fact, Trump promised “insurance for everybody” with “much lower deductibles" and lowered drug prices -- and that the final touches are being put on it and so it's coming soon. True, that's wildly out of sync with what Republicans have promised, not only in coverage, cost and timetable, but what are mere details between friends? And beside, "We haven't put it in quite yet," he said -- oh, darn that pesky "quite yet." And so we wait for the joint details. And wait and wait... A couple of weeks ago, though, I heard an explanation from journalist Steven Brill on Lawrence O'Donnell's show as to why none of that from Republicans will happen. And it was simple, and easy to follow and made more sense than any of the other explanations we've all heard for the past few years.
We certainly know, of course, all the promises for this even better and even less-expensive national health care. And we certainly haven't heard any plans to describe the specifics -- or even the generalities, unless you count "better and less-expensive" as a general health plan. Or "quite soon" as a general timetable. And we've heard, too, Republicans and Trump try some flim-flammery with "repeal and delay." The sort of "Trust Us, Folks" gambit, where they try to get points by putting off off the "even better and even less-expensive" non-existent plan until after the next election, hoping that the voting public will be razzle-dazzled into forgetting that there isn't anything.
We've also heard Democrats explain in specifics why it's not possible for Republicans to come up with a better and less-expensive plan, noting that if you take away one part of the three-prong program then it all falls apart. And they go into details, and the details are all correct, though it's still a matter of juggling numbers, so it sounds convoluted. It also sounds like it leaves the door open for someone to be able to figure out how to do it. Even if the door isn't left open for replacing a 2,000-page law.
Steven Brill's explanation, though, as I said, is oh-so-much simpler and more clear.
The way he explained why the Republicans and Trump won't be able to come up with an even better and even less expensive national health care plan is -- the Affordable Care Act IS a Republican plan!!
Before the ACA was passed, you'll recall, Democrats wanted a single-payer system, something along the lines of national Medicare for everyone. But to pass at least some sort of national health care, they compromised and used the plan that had previously been developed by the conservative Heritage Foundation. And so they based the ACA on the plan which a few years before had been passed in Massachusetts when Republican Mitt Romney was governor, to the degree that it was known as Romneycare.
So, Republicans can't come up with an even better and even less expensive plan than the Affordable Care Act because the Affordable Care Act is the best and least expensive plan that Republicans themselves have already come up with!!! If Republicans were able to come up with an even better and even less-expensive plan...they would have. But for 11 years, since so-called Romneycare (in a liberal states with a liberal assembly)...That Is Their Best. It's their plan.
So, don't keep holding your breath for them doing better. I hope they do. The problem is that they don't hope they do. Because when the Affordable Care Act was brought before Congress they hated it, hated how much it covered, hated how much money the federal government subsidized it with, hated the price controls and fought tooth-and-nail like outraged dogs to try and defeat what, in reality, was their own plan.
And given that this is their own plan, it's a pretty safe guess that they themselves know this.
That means there are two possibilities. The first is that they will not be able to replace the ACA with anything better, and therefore will leave it in place, despite their own push toward "repeal." -- which won't kick in until they actually do come up with something, which they won't. The other possibility is that they do replace the ACA with something, but by GOP-necessity it will be worse and more expensive. And the public (which actually likes the ACA more than not and doesn't want it repealed) will be really pissed off, and the Republican Party will be screwed.
So, ultimately, whatever the Republican Party ends up doing -- no replacement or worse -- we know that they can't come up with an alternative that's even better and less expensive because they're already on record wanting to repeal the plan in place...which is their own.
And on January 20, the Pottery Barn Rule kicks in -- you break it, you own it.
Robert J. Elisberg is a political commentator, screenwriter, novelist, tech writer and also some other things that I just tend to keep forgetting.
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