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Why Trumpcare is so awful: Obamacare is the most conservative plan Americans will accept

June 28, 2017

Recent polls have shown that Trumpcare — which gestated for seven years in the steamy Jiffy Pop head of Paul Ryan — is about as popular as the many debilitating preexisting conditions it’s designed not to cover.

 

According to a Wall Street Journal/NBC poll released just before the Senate unveiled its version of Trumpcare last week, only 16 percent of Americans have a positive opinion of the House’s bill, compared to 48 percent who hold a negative view. If anything, the Senate bill is even crueler than the House version, which Donald Trump famously called “mean.”

 

There’s a good reason why the GOP plan is so awful and unpopular: Obamacare was already a pretty conservative law, and among the few options left for legislators bent on repealing it, “draconian crapshow” was the only one conservatives could plausibly accept.

 

For years Republicans painted Obamacare as an ultra-liberal — even socialistic — government takeover of the health care system. So when they finally regained control of the Senate, House, and White House, they should have had an easy time crafting a new health care law that was palatable to a majority of Americans, who have always at least claimed to be skeptical of liberal, socialist, big-government health care solutions.

 

That is, unless Republicans were lying about Obamacare’s socialist bona fides all along, which would mean confusion and finger-pointing would inevitably rule the day.

 

So which of those scenarios has come to pass? It should be obvious by now that Republicans have bumbled through Door No. 2.

 

Medical economist J.D. Kleinke foresaw this clown show in a savvy column he wrote for The Huffington Post back in January, when Republicans were still stumbling in the dark (as opposed to face-planting in the light, which is what they’re doing now).

 

The column is a great read, but to get the gist of it, all you need to see is this chart, which maps out the entire spectrum of possible (i.e., workable) health care reforms:

As Kleinke notes, this chart is comprehensive. There may be subtle hues between the options represented on this rainbow, but you can’t move to the right of Obamacare without transforming our health care system into either the cruel, unsatisfactory, and unsustainable status quo that Obamacare was designed to replace or a completely libertarian model in which the sick and soon-to-be sick (i.e., all of us) are given the government’s sincerest best wishes and told to fend for ourselves.

 

Medicare for All, which Bernie Sanders has championed, is as simple as it sounds. All Americans would be covered in the same way Medicare recipients are covered now. According to Kleinke, managed competition, which Bill and Hillary Clinton proposed in the early ‘90s, “achieves universal access by mandating employers and individuals to participate and by requiring everyone — with or without current coverage — to give up what they have and commit to one of several competing vertical insurer/provider entities.” In other words, it retains the flavor of a free-market system while avoiding the socialistic overtones of a Medicare-for-all plan.

 

Given the unpopularity of Trumpcare, many observers have marveled at the GOP’s insistence on going forward with their muddled and likely ruinous repeal-and-replace legislation, because that looks like political suicide. Well, that’s because it is political suicide, but Republicans have painted themselves into the tightest of corners.

 

They can’t propose a bill that’s to the left of Bernie Sanders’ proposals, nor can they make common cause with the Vermont democratic socialist by embracing a Medicare-for-all system. Hillarycare was considered and rejected long ago. And after building their congressional majority and taking back the White House on the strength of their seven-year opposition to Obamacare, they can’t just say, “Oh, only kidding. Obamacare is a pretty good system after all. Let’s just call it something else.”

 

But what Republicans have evidently failed to consider is that, to the extent that Obamacare is unpopular, it may be so because it’s too conservative. An April The Economist/YouGov poll found that 60 percent of Americans support providing insurance to all Americans through Medicare, while only 23 percent oppose the idea.

 

So Trumpcare is what it always had to be: a hybrid bill that’s to the right of Obamacare (which is already about as conservative a law as Americans will accept), but which isn’t quite as brutal as whatever Rand Paul’s febrile mind might have cooked up.

 

Republicans are in a no-win situation, which is why they’re running scared. They really are committing political suicide, but to be fair, the only choices left to them are to die by one of their opponents’ swords or to fall on their own. They’re choosing the latter, which for some reason they view as the more honorable solution.

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