The number one priority of the Republican Congressional caucus is to axe Obamacare. Regardless of the fact that the GOP haven’t got their act together on health care, they are just carrying on with their policy of the past eight years - oppose everything Obama. Within four years of Obamacare introduction they had moved no less than fifty- four times for its repeal. Juxtaposed with this obsession is the fact that Obamacare, for all its deficiencies, has been around almost seven years and has provided up to 30 million uninsured Americans health care. The number of citizens signing up for 2017, with the sword of Damocles hanging over the Affordable Health Care Act, (ACA aka Obamacare), was nearly seven million. All this going on while the Donald marches to his own drummer.
EVERYONE WHO SHOULD BE THERE IS THERE
The country is prepared for a gigantic struggle as both sides gird themselves for a long drawn out battle. President Obama has taken the unprecedented step of physically going up to Congress to rally the Minority Caucuses to fight the repeal. Simultaneously Vice President elect Mike Spence is up on Capital Hill to keep the unruly House of Representatives in line. It is not so surprising that he needs to get the line straight even on Obamacare. In case one had forgotten the Republican House of Representatives are deeply split and on day one the rebels were forced to back down on their desire to rid themselves of the Ethics Oversight Committee by no lesser personage than the great POTUS elect Donald J. Trump - by tweet of course. Now there’s irony for you!
To get back to Obamacare, with all its problems, many of those who voted for Trump are those that are benefiting from it. So if Trump is true to his populist stance are we on the cusp of a major split between Trump and his Legislative Branch?. What is the replacement? Trump has none and neither has GOP Speaker Ryan nor Senate Majority leader McConnell. So far it appears that it boils down to telling patients to fend for themselves as this is costing too much and the monopolistic market place will sort it out for them. The health care industry have a ton of money riding on keeping the gravy train going so they will lobby to see it that Obamacare in one way or another continues.
ALL GOP CONSTITUENCIES AGREE ON AXING OBAMACARE BUT THEN WHAT?
Now one of the items where all the GOP legislators and the POTUS agendas ostensibly agree on is the repeal and replacement of Obamacare. Ryan, McConnell and Trump were ad idem on this agenda. They are all strong on the repeal part and even after seven years of its existence very weak on its replacement. One of the problems is that the populist Trump is in favor of all the key provisions of the ACA. These include not excluding anyone from insurance on the basis of “previous conditions”, including all children on insurance up till the age of twenty - six, not setting a life long limit for benefits and covering everyone with health care. In addition Trump was against removing Medicare and Social Security which are on the block in the Ryan Republican budget plan together with their putting Obamacare to rest. For Trump opposing Obamacare was just one of his rah rah lines together with the building of THAT BEAUTIFUL wall. However, he has forced himself into a corner so Obamacare will have to go.
THE HEALTH CARE MESS
Now Health Care in America is in the most imaginable mess. The Health Care/Industrial complex has taken over from the Military/Industrial complex as the number one economic powerhouse in America. One in every six dollars, (sixteen percent of GDP), spent in America is on health, or should Jay H. Ell say, sickness care. The number one reason for bankruptcy in the USA is failure to pay health care bills. There are three thousand health care lobbyists in Washington by far the most for any government department. There are thus six lobbyists for each member of Congress on Health matters. So whether Obamacare comes or goes cost is out of control and there is a powerful interest group that want to keep it that way.
Trump by interfering inherits the mess and takes onus of it. He said he was going to fix it and he can’t.
AMERICAN MEDICAL ASSOCIATION
The conservative American Medical Association has taken a determined stand on the matter. In a statement their CEO, Dr. Madura, has urged Congress to take steps not to allow the gains in patient coverage afforded by the ACA to be lost. He urged the GOP to present their replacement policies in reasonable detail. A skeptical Dr. Madura maintains that once the Republicans have produced their plan citizens will be able to compare this with the current ACA and presumably choose! He continues that the AMA would welcome a policy to make plans more affordable, provide greater coverage and enroll even more uninsured. While offering to work with the Administration the AMA have unequivocally backed the principles in Obamacare and are agitating for its improvement.
The AMA is an extremely well funded and a very influential player in this scenario. In fact they were largely responsible for blocking Hillary Clinton’s health care reform efforts in 1992. Together with the health care complex they are going to fight every attempt by the Republicans to cost cut.
THE CONTEXT -, MINORITY RULE AND THE MILLION POUND RUSSIAN BEAR IN THE ROOM.
In addition to the health care mess and all the influential side players, it should not be forgotten that this battle is taking place in an environment where the Administration and Legislature have not the backing of the majority of Americans. Three million more voters voted for Clinton and there was well over a million more Democrats that voted for the legislature. Only the peculiarities of the electoral college and the Republican gerrymandering of the constituencies allowed the Presidency and the Legislature to be in Trump and GOP hands. The reaction to the axing of the ACA could be sharp especially if nothing is put in its place. The protest meetings are already in the wings and petitions are floating across cyberspace. In addition if Trump goes the whole way with the GOP Congress and doesn’t stick to his populist stance on this issue he may well start to unravel following his inauguration.
By way of the deafening background music the split between Trump and the GOP legislature on the Russian hacking is vocal, total and unambiguous. Speaker Ryan expressed the hope that Trump will see reason after his intelligence briefing and McConnell has given up on arguing. Trump has denigrated and smeared the intelligence community in favor of his newest best friend Putin, whom his GOP Legislature regard as a thug and a murderer. The POTUS elect has not a majority in the Senate on this issue, several Republicans including McCain, Graham, Sasse, Sullivan and Rubio have declared themselves categorically against Trump’s mother Russia. Unlike Obamacare there is no wiggle room on this issue. Supporting and quoting Julius Assange who has been called a cyber terrorist by GOP members has to be the last straw.
Maybe all this is why they are going ahead on repealing Obamacare - it is the only issue they all agree on. They will play it by ear thereafter. Maybe just repeal it for show and leave all the provisions intact.
AT THE END OF THE DAY
* Where this is all going nobody knows but America is in for one long tweet.
* Who knows when Trump fatigue will finally set in?
* Jay H. Ell wonders when the GOP deprive thirty million Americans from health care whether they will believe that they, after eight years, finally have done something.
* Trump never backs down, well hardly ever, so what is he going to do with Putin and Russia as his position grows more and more insane? Watch this space.
* At least the stock market is going up on all those positive financial promises such as lower taxes and no regulations so that the company profits will grow even if they do nothing more.
* Can’t wait to hear the inaugural it just has to be a doosie. Do you think he will lead the crowd in "lock her up"?
* If it wasn’t so serious it would be funny……
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