Getting “the Genie back in the bottle” is an often used metaphor in the world of policy and politics. It just works for so many things, it actually takes discipline for me not to overuse it. There are people in the political world who have the opposite problem though. They don’t recognize when the Genie is out of that bottle, and there is no way to ever her get her back in it.
That is today’s GOP in the world of healthcare policy.
Take it easy conservatives, this is not necessarily a critique of your fundamental desire to respect markets. I share that respect whenever possible. Healthcare in America is no longer a market though, it hasn’t been since before the ACA passed, and it never will be again.
Charles Krauthammer, the conservative columnist and scholar who I enjoy disagreeing with whenever he appears, said some things I agree with nearly two months ago on the issue. He said while he believes Obamacare failed at every level, that on the ground, the electorate now sees healthcare as a right. Further, he believes that Republicans are acknowledging this in their approach and that within 7 years, we will operate in a single payer system. He explained we will never get back to a market based approach.
Krauthammer said “The electorate sees healthcare as not just any commodity, like purchasing a steak or a car. It’s something now people have a sense the government ought to guarantee.” I agree with him, though it pains me less when I acknowledge it as true.
And that is the ballgame people. That is the reason the latest version of the Congressional plan to “repeal and replace” is so unpopular. Americans will not support a plan that provides less access to healthcare, or less of a guarantee than the one they already have.
Yea, yea, I know all about the campaign trail and the outcome of the elections last Fall. But pay attention closely to what was promised, and what voters actually believed. None of it meant that in reality, the GOP never had a plan that would provide better access to quality healthcare at lower prices for Americans “on the ground.” I use that descriptive because “on the ground” Americans are not the ones getting the tax breaks in the GOP plans.
What Americans thought they were voting for was a better plan or at least an improved plan. They voted for a situation that would be better than the one they already had. Nearly eight months after they voted for that, the GOP Congress isn’t even trying to convince us that the plan they want to pass is any of that. Their so-called better idea is simply that bad.
These are brand new Republican voters who are being betrayed on their first date. These new supporters of the GOP don’t represent campaign contributions, but they do represent votes. And they are the reason Donald Trump is president. They believed him when he said how great healthcare was going to be. They scoffed at the liberal elite for making fun of Trump when he proclaimed “nobody knew healthcare could be so complicated.” They have tried to stay loyal to the government they elected.
Now it’s decision time though, and cooler heads are doing the math. And the math doesn’t add up.
Americans now expect healthcare will be available to them when they need it. Why shouldn’t they? In the richest country in the world, and regardless of politics, we will not let someone needlessly suffer or die just because of their insurance status. Which, like Krauthammer said in May, is how and why our country’s policy will become single payer based. Sooner or later, this will happen.
I had a professional mentor say to me many years ago on another “genie in the bottle” situation that “we have already established who we are, now we are just haggling over the price.”
That is what the healthcare debate is today. Both sides of the aisle agree that healthcare is something our citizenry should have. The 22 to 24 million people the Congressional Budget Office predicts will not be insured if either GOP plan is implemented is intolerable to the electorate. Americans want that number to be zero.
Let’s quit fighting about the things we agree on, be honest with each other and get down to the business of haggling over the price.
The Genie won’t ever fit back in the bottle on this one. Coming to grips with that is the first step toward coming up with a plan that might actually work. Assuming of course, that’s what leadership in Washington actually wants.