Monday, March 13, 2017


The voters in 2016 not only elected Donald Trump president,
they returned  Republican majorities to the U.S. house and
senate. They did the former for a variety of reasons that
included candidate Trump’s promise to sign a repair to the
failing Obamacare health reform system. They did the latter
with more focus, to wit, a clear expectation that the Congress
would, with a GOP president ready to sign the bills, legislate
to reform unpopular and failing public policy, including
repeal the old Obamacare and come up with a workable and
reasonable replacement that would enable millions of
Americans to purchase healthcare insurance in the open

Speaker of the House Paul Ryan has, with his colleagues,
fashioned both a repeal and a replacement that not only goes
a long way to fix the current system, but also might pass with
the necessary majority in the U.S. house. It’s not perfect. Each
person might have a specific suggestion or two to make it
better, but as Speaker Ryan knows, an element of compromise
is always required for major legislation. Improvements on this
legislation could be made in future sessions. It is a work in

Real reform provides healthcare insurance for an individual
who is able to choose a plan he or she can afford with coverage
he or she wants from competing insurers. It takes healthcare
decision-making away from bureaucrats in DC, and puts it
back where it belongs --- with patients and their physicians.
The use of tax credits enables millions of citizens without
coverage to have healthcare insurance.

Obamacare did not cover everyone, nor can its replacement.
A “pure” insurance program would leave too many Americans
with access to no healthcare at all; but the public wants a
more humanitarian  program --- and for good reasons,
illness and disease affects not only individuals, but all those
around them, including the community at large. Admitting
indigents repetitively to expensive emergency room
treatment is actually more costly than providing healthcare
insurance. Lack of treatment, vaccines and other preventative
healthcare measures leads to epidemics and unnecessary public
health risks and expense. By offering a choice of reasonable
coverages, caps and limitations, adequate health insurance can
be made available to most Americans without the numerous
inherent shortcomings. of Obamacare, a program which not only
failed to fulfill its promises, but which immediately saw rapid
and unacceptable rising costs with no end in sight.

Those conservatives who are demanding a “pure” bill are
ignoring political reality. In fact, if they prevent passage of
the legislation, they will in effect be ensuring that Obamacare
will continue. Voters who voted Republican in 2016 because of
the promise of repeal and replacement will not be, shall we say,
pleased. They will have every right to express themselves in
2018  when the entire U.S. house will be up for re-election.

House passage does seem possible, but the legislation is more
problematic in the U.S. senate. More compromises will be
likely. Nevertheless, the tiny GOP senate majority faces the
same voter expectations as do their colleagues in the house.
That small majority would be expected to grow, even
substantially, in 2018 because so many more Democratic
incumbent seats are up for re-election, but this opportunity
would disappear if the GOP control of the federal government
fails to produce change and reform.  Conservatives could even
lose the senate in 2018 if they fail to fix Obamacare and keep
their other promises to reform public policy.

Since 2009, I have warned that Obamacare was a policy and
political disaster, and the mid-term elections of 2010 and 2014
proved that assertion correct. As I have also suggested, it was
one of the keys to 2016. Now the shoe is on the on the other
foot. No reasonable excuse could be made by the conservative
party if it fails to keep its promises. Ideological purists, both on
the right and the left, do not promote solutions. Instead, they
promote stalemate in the name of abstractions.

President Trump supports his congressional partners in the
promised fulfillment of fixing Obamacare. It’s time right now
for positive action on Capitol Hill.

Copyright (c) 2017 by Barry Casselman. All rights reserved.

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