Health Care Reform in Surgery Recovery

Arizona Sen. John McCain is currently recovering from surgery, and for as long as that takes so is his Republican party’s attempts to reform America’s health care system.
Senate Majority Leader Mitch McConnell of Kentucky has once again delayed a vote on a Senate health care proposal, not because McCain is a former party presidential nominee or exceedingly senior congressional member or otherwise an especially respected member of the party, but rather because at this point not a single a Republican vote can be spared. This point arrives after seven years of every establishment Republican and every anti-establishment Republican vowing repeal and replacement of the hated Obamacare law, with a solid Republican majority in the House and a sufficient one in the Senate and some sort of Republican in the White House, so the Republican effort to make good on that constantly made promise seems conspicuously sickly.
The prognosis for McCain’s recovery is reportedly good, and we certainly wish him our very best and offer our prayers, but the chances for that long-awaited Republican repeal and replace effort seem more iffy. Health care is complicated, as that putatively Republican president discovered shortly after he took office, and the politics of the issue are more complicated yet, so it’s foolish to make any bold promises such as the all of the Republicans have been making. The party’s congressional majorities might yet pass something, and that some sort of Republican president will surely sign it, but at this point there’s no guessing how that might turn out well.
That hated Obamacare law is indeed hateful, full of all the restrictions on individual liberty and increased costs for the middle class that the Republicans predicted, utterly lacking in the promises the Democrats made about keeping your doctor and your plan and pocketing a big chunk of change at the end of year, and the Republicans won three state congressional election and one-of-two presidential elections on the issue. The law never polled well, even when Obama was winning re-election, so replacing the damned thing should have been an easy enough task for a Republican congress and Republican president to do. Replacing it, though, has proved tricky even for the co-author of “The Art of the Deal.”
Some of Obamacare’s most unworkable provisions have always polled well, such as that guaranteed coverage of pre-existing conditions, and at least a few million photogenic and sympathetic folks have derived advantages from it, and it also expanded Medicaid coverage to a few more million folks in states that voted in Republican governors and senators and representatives. Obamacare still doesn’t poll particularly well, but both the House and Senate versions of repealing and replacing it are faring far worse, and at this point in this age of cynical pragmatism we can’t hardly blame any Republicans up for re-election in a year and a few month’s time.
Those poor politicians’ political calculations are further complicated by the complex nature of Republican politics at this point. One of the unsure Republican votes is Sen. Susan Collins of Maine, who voted against Obamacare when it happened and is about as right-wing a Republican as you could hope for in a such a liberal state as Maine but is nonetheless reviled by the all the right-wing radio talkers in the red states and is voting against the Senate bill because it’s too austere. Another wavering vote is Sen. Ran Paul from McConnell’s own state of Kentucky, whose standing with the right-wing radio talkers is hard to assess at the moment, because the thinks the bill too spend-thrifty. Texas Sen. Ted Cruz is holding out for an amendment that would allow young and healthy consumers the choice of low-cost and low-coverage plans for catastrophic care, which warms our traditional Republican hearts, but the Republican president called him “Lyin’ Ted” all the right-wing talk radio hosts aren’t sure what to make of the Cruz amendment.
Almost everyone on talk radio and the rest of the party still seems on board with that putatively Republican president, who ran on promises of coverage for everybody and the government paying for it and no cuts to Medicaid and lower costs somehow resulting, and he now tells his televangelist interviewer that he’s waiting in the Oval Office with his pen to sign anything the Republicans might put on his desk. He’s not given any speeches or even any “tweets” about why the Republican plan is so great it’ll make your head spin, but if the Republicans in congress do give him something to sign he’ll gladly take credit for it. If they don’t, he’ll be able blame it on those gutless and devious moderate and conservative establishment types of Republicans that he that he vowed to destroy, and we’re sure all those talk show hosts will heartily agree.
There’s a Republican case to be made for those widely unpopular House and Senate bills the Republicans came up, and for the compromise that should have been reached with complete Republican control of the government, and they might yet make it. Such Republicans as that putatively Republican president keep talking about how shrewd McConnell is at getting things done, and we note that he held a Supreme Court seat open long enough for the putatively Republican president to take credit for getting a conservative confirmed, but the Republican president ran on the argument that he or any other professional politician couldn’t get anything done, and that only a real estate developer could do the job.
If the Republicans don’t get the job done there will be plenty of blame to spread around, and we’re sure they’ll all do their best to spread it elsewhere. If something does get passed and sign, they’ll probably all claim credit, then start deflecting the blame somewhere down the electoral road.

— Bud Norman