2017 Mar 30^th

Today we have Patrick Buchanan writing a column the burden of which is the position that the defeat of the Ryan/Trump care bill was in fact no defeat at all but a victory. Buchanan even titles this column, “The Ryancare rout: Winning by losing.” The logic of Buchanan’s position is that with the failure  of the “American Health Care Act,” the ACA (Obamacare) was left firmly in place as the law of the land. Buchanan has bought into the notion that the ACA will certainly fail, so now that it has been resurrected we can wait for it to expire of its own inadequacies.

Buchanan makes some curious comments: He says about the ACA, “And the Democrats now own it again, as not one Democrat was there to help reform it.” So Buchanan would have us believe that the Republicans were willing to reform the ACA but the nasty old Democrats just refused to help. Buchanan has a long history of believing myths but the notion that the Republicans wanted to reform Obamacare but the Democrats wouldn’t help them is one of his best.

Next to building the wall, “that big beautiful wall” repeal and replace Obamacare has been Trump’s mantra ever since he first appeared on the political horizon. Before Trump appeared, repeal and replace had been the Republican rallying cry ever since the ACA was passed…and it was passed without a single Republican vote. (One might add here that over thirty Democrats voted against the bill.)

The point here is that for about seven years the Republicans have complained about the ACA and said they would replace it, presumably with something better, but when they had the chance to replace it they blew it. The replacement they put forward was approved by just 17 percent of the population and it was opposed by every nearly every professional health organization.

The problem was that the Republicans were unanimous about the repeal part but severely divided about the replace part. About 36 House members are part of the very conservative Freedom Caucus. These people would rather not see any social programs at all and certainly not something like the ACA. So what does the Speaker of the House do to win over members of this group to vote for the replacement bill? Speaker Ryan removes the healthcare essentials insisted on by the Democrats. Obamacare mandates that all health insurance plans must cover “ten areas of “essential health benefits”: Doctor’s visits, emergency services, hospitalization, maternity care, mental health and substance abuse treatment, prescription drugs, lab tests, pediatrics, rehabilitation, and preventative services.

Once these “essentials” have been removed, what’s left? Damned little, so this emasculated health care bill lost the votes of moderate Republicans, failed to pick up the votes of the Freedom Caucus members and poor Ryan had to go to Trump and tell him his initial legislative effort would fail if it was pursued. The only recourse was to pull the bill so officially it would not go in the record as a legislative lost.

Buchanan says this loss is really winning?