Molly Kiniry:
‘It is the sort of human misery which no responsible government should inflict upon its own people’
The abrupt departure of White House spokesman Sean Spicer is making headlines this weekend. But do not be distracted by the sideshow playing out in the West Wing. This week’s moment of real significance was the collapse of Republican efforts to scrap the Affordable Care Act, otherwise known as Obamacare.
Since it became law eight years ago, Republicans have been singularly focused on repealing and replacing Obamacare. President Trump made its “termination” a priority for his first day in office. Yet six months into his presidency, with Republicans controlling both houses of Congress, efforts to scrap it have failed again. So who’s to blame?
Answering that simple question requires a level of allegiance-mapping ordinarily reserved for Game of Thrones. Some point to Mitch McConnell, the Senate Majority Leader who failed to corral his party (let alone the chamber as a whole) into passing the Obamacare replacement. Others say McConnell was left with an impossible task by Paul Ryan, the Speaker of the House of Representatives, who steered the bill through the lower chamber, fully aware that it would be dead-onarrival in the Senate.
But the sad truth is that this morass is no one’s fault. Rather, it is a symptom of a deeper disease in Washington. The modern twoparty system prevents meaningful legislative action except in emergency situations. Individual politicians are so dependent on the party machine that none will break ranks, even if their constituents would benefit from bipartisan cooperation. Disloyalty to the party can lead to swift retribution, in the form of primary challenges or an evaporation of funding.
The result is that not a single Democrat has been brought onboard in the House or the Senate to back Republican healthcare plans. This is not surprising, nor is it ideal: one-sided legislating produces bad outcomes (the most recent example being Obamacare itself).
It’s not just the legislative process that’s creaking. The parties themselves are hugely overextended, because they must cover so much political ground. For Republicans, the imperative to absorb every voter who believes in limited government has created strange bedfellows:
Tea Party radicals, libertarians, and traditional conservatives. Each faction played a part in this week’s latest legislative failure. Two conservatives objected that not enough was being repealed in the new bill; a libertarian defected because of massive health insurance subsidies for low-income Americans; and a moderate refused to lend her support because it cut too much funding from Medicaid. It’s a Goldilocks problem without a “just right” solution.
Where, in all of this, is Trump? He has incongruously praised singlepayer systems in Canada, Scotland, and Australia; he has bemoaned the complexities of healthcare, which “no one knew” about; and even suggested that the entire American healthcare system should be allowed to fail before it is rebuilt. Such stream of consciousness contributions have not helped to solidify support, or engender much public confidence in, Republican proposals. But the President has succeeded in diverting attention for their failure to Congress.
This blame game leaves us with few viable solutions. Either allowing Obamacare to remain federal law, or repealing Obamacare without replacing it, would be a spectacular abrogation of duty from Republican lawmakers. Mr Trump’s suggestion that the whole system should be allowed to go down in flames might sound like a reasonable response to congressional thumb-twiddling, until one remembers that we’re not discussing an outmoded, inefficient car manufacturer here.
A failed healthcare system means sick children out of school, and missed cancer diagnoses. This is the sort of human misery which no responsible government should inflict upon its own people – and precisely the sort of indifference which has relegated the Republican Party to pariah status among those concerned about the welfare of America’s poorest.
The Party has not done enough to explain its values – what George W Bush described as “compassionate conservatism” – where the state does not stand in the way of the creation of prosperity, and ensures that a safety net exists for those unable to pull themselves up. The next round of healthcare talks must embody this vision, increasing consumer welfare by, for example, allowing Americans to shop for health insurance across state lines. Encouraging competition in the market, and thereby increasing choice, would guide the GOP back to its roots as the party which zealously defends the freedoms of all Americans.