Sun Sentinel Broward Edition

Trump’s health care collapse lessons

- By Michael Dobie

Lessons matter only if they lead to changes of behavior. And this isWashingt­on. So the jury is out.

One learns more fromfailur­e than success, or so the saying goes. But in the collapse of theRepubli­can attempt to repeal and replace Obamacare, therewere lessons aplenty for both winners and losers.

President DonaldTrum­p. He says he learned a lot, and he should have.

First: Politics is not business. Art-of-thedeal principles don’twork inWashingt­on. You can’t deliver an ultimatum and threaten towalk away if it’s not accepted.

Second: Details matter. You can’t talk in broad strokes about better and cheaper and beautiful, then let others fill in the picture.

Third: Trump says he’s an instinctua­l person and that his instincts are always right. Whatever one thinks of that, his instinct that eventually Democrats willwant towork with him on a legislativ­e fix for Obamacare is sound. In fact, Trump ought to pursue that. Paging Chuck Schumer, who is not a natural leader of a resistance­movement. He, too, likes making deals.

Fourth: Trump learned the conservati­ve Freedom Caucus is not his ally. Thatwas clear when he talked Friday about doing a bipartisan health care bill. And if thatwas just awarning shot for issues like tax reform, Trump learned something about governing and unlocking gridlock inWashingt­on.

Fifth: Trump said he learned a lot about loyalty. He’s used theword before to separate friends and enemies. But using health care positions as a litmus test, and running staunch conservati­ves in primaries against bill opponents in 2018, could easily lead to Democrats winning those seats.

PaulRyan. He learned that he has a partner without principles, other than winning, whatever Trump thinks that means. He learned that being a purist is one thing, being transactio­nal is something else. Trump bargained with the Freedom Caucus independen­tly of Ryan, forced a votewhenRy­an didn’twant one, then claimed hewas the one who canceled it.

Congressio­nalRepubli­cans. They learned that when you say you’re against something, you’d better knowwhat it is you’re for. They never had to do that while Barack Obamawas president, then found their factions have very different health care visions. It’s a lesson Democrats should take to heartwhile they’re in the minority. Other big issues loom, and reflexive opposition might feel good, please core supporters and be effective in the short term. But eventually, they’re going to have to say what they support, and they also have stark divisions within their ranks.

Congressio­nal Democrats. They learned that sometimes you can win by letting theRepubli­cans self-destruct. But they should resist the temptation to take away a different lesson: that “their” victory is a mandate to filibuster­Neil Gorsuch’s nomination to the Supreme Court.

Trumpvoter­s. They learned that Trump will abandon them, when he agreed to stop requiring that policies offer essential benefits like coverage for mental health and drug addiction issues, hospitaliz­ations and emergency services. As he did that, PrincetonU­niversity economists Angus Deaton and Anne Case released a study showing that less-educated middle-aged white Americans— Trump voters— are dying in disproport­ionate numbers fromsuicid­es, drug overdoses and alcohol-related diseases. Deaton andCase call those “deaths of despair.”

Town-hall activists. They learned the power of loud voices, especially in swing districts. They turned out in force to say they didn’twant to lose their coverage. House members like Staten Island’sDan Donovan, where residentsw­ould have lost coverage and Barbara Comstock, whose northernVi­rginia districtwe­nt for Hillary Clinton by10 points, listened, defiedRyan, and announced their opposition. That feelgood lesson— that representa­tive democracyw­orks— will embolden these new activists.

Of course, all lessons matter only if they change behavior. And this isWashingt­on. So the jury is out.

Michael Dobie is a member ofNewsday’s editorial board.

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