Sunday, September 24, 2017

Why Graham-Cassidy Bill to Replace Obamacare Should Fail

The Graham-Cassidy bill – the latest Repeal and Replace iteration - still has a pulse, but its prognosis is grave.   While we physicians generally avoid predicting outcomes, my sense is that this bill will be buried in the coming days.  I presume that once its passage becomes mathematically impossible, that the bill will be pulled.

Of course, failure to Repeal and Replace is a horrendous embarrassment and exposure of the Republicans who have been campaigning and crusading against Obamacare with religious zeal these past 7 years.   These patriots knew they could safely rail against the Affordable Care Act (ACA) – throwing red meat to their base – knowing that the bills would never pass while a Democratic president occupied the White House.   How ironic it is that now that the GOP have congressional majorities that they couldn’t get it done.  Not only could they not run the ball into the end zone, but they repeatedly fumbled at every opportunity into the hands of waiting Democrats. 

It seems to me that the GOP efforts to ram though a New & Improved health care program was all politics and very little policy.   The objective was to get a 'win'. Numbers were massaged.  Special deals were offered.  The non-partisan Congressional Budget Office was bypassed.  False promises were made.  Doomsday predictions were declared.  All this is public knowledge.  Imagine what was happening beyond our view. 

I have been consistently hostile to Obamacare, which I have regarded as a waystation on the path toward full government takeover.  Readers are referred to various rants on this subject in the Health Care Reform Quality category along the right margin of your screen.  But my animus toward the ACA doesn’t mean that I’ll support anything offered up as a replacement.

Someone deserves a thumbs up here.  

I didn’t like it when the Democrats passed the ACA without a single Republican vote.   This partisan victory created a chasm that divided the parties and the country which lives still.  While the Democrats will claim that no Republican would work with them then (really?), they could have made some compromises to draw in some GOP legislators and still pass the bill.  Was it simply beyond the Democrats’ ability or willingness to include tort reform in the bill, for example?  How different would our political landscape be now if both sides had contributed to health care reform?

I don’t have a firm opinion on the merits of Graham-Cassidy, but I do not like the process of trying to jam it through before the end of the month so the GOP can utilize the reconciliation process, where only 51 votes are needed, rather than 60 votes.   A decent bill should be able to withstand congressional vetting and inquiry and should be able to draw 10 or so Democrats on board, assuming naively that they would be permitted to vote their conscience. 

I think that Lindsey Graham knew in his heart that his closest friend in the Senate, John McCain was going to give the thumbs down again.   I give him a thumbs up for being the principled and heroic statesman that we so desperately need.  

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