AMEND CORNER: Who knew health care could be so complicated


Ever since November, Republicans have been gloating about what they would do when they took office.

They did take office, but a funny thing happened: Things didn’t work out the way they had planned.

Last week, they couldn’t even keep their biggest promise, to repeal the Affordable Care Act. A vote on a replacement didn’t happen, and the Chief Promiser, President Donald Trump, said he was going to quit trying.

That doesn’t mean Congress won’t try again, but first, the Republicans have to figure out a way to get themselves on the same page. That might take some doing. Consider Speaker of the House Paul Ryan’s statement after he decided not to have a vote on the issue. Among other things, the speaker said they would have to get together and figure out what went wrong. Well, if he doesn’t know what went wrong already, he isn’t smart enough to be the Speaker of the House, and I would bet that more than a few of the Republicans he’s supposed to lead are probably making the same judgment now.

Republicans should have seen this coming.

Seven years ago, they decided to respond to the passage of the ACA by changing its name to Obamacare and convincing people it was a dirty word. This, of course, played well with all the ultra-conservatives who don’t think the government should do anything that doesn’t involve the military. Regular Republicans supported the effort for the more honorable reason that they want smaller — that is, cheaper — government so they could balance the budget and cut taxes. They kept calling for repealing and replacing the ACA, but, unfortunately, they weren’t all together on the question of what the ACA should be replaced with, if indeed they wanted to replace it at all.

Because the Republicans weren’t all on the same page, they spent the past seven years voting for repeal, even though they knew President Obama would veto the repeal. And they didn’t pay attention to the fact that Obamacare was helping a lot of people buy health insurance. They simply came up with a plan that would be cheaper and free up money for tax cuts, and didn’t really look at the impact it would have on those people — a mistake smart politicians wouldn’t make. They also just brushed aside the fact that their president had promised a new “beautiful,” pie-in-the-sky Republican plan that would keep all the popular parts of the ACA while having lower premiums and deductibles. Even so, President Trump agreed to put his influence, such as it is, behind it.

Then Rep. Ryan tried to put the Republican plan to a vote and get it passed before anyone had time to study it. Unfortunately for him, though, it didn’t work. For one thing, many voters who had believed President Trump’s promises came to understand that Obamacare, which they had been told to hate, and the ACA, which had helped them buy insurance, were the same thing. They began to show up when their Congressmen held events and yell at them, sort of the way tea partiers did back in 2009. Some Republican members of Congress were actually afraid to meet with their constituents. It got worse when the Congressional Budget Office released their analysis of the Republican plan, which found that some 24 million Americans — many of them likely voters — would lose their health insurance under the plan.

Another complication for Speaker Ryan and the president came from the bomb-throwing Republicans who want to blow away all social spending. They would not support anything but the complete elimination of the ACA. That doomed Rep. Ryan’s bill, and he knew it, so he called off the vote.

The sad part of all this is that, while the ACA is working and has helped many people obtain health insurance, it has flaws, including some that may make the system unsustainable. But before tossing the law completely, Congress should make a serious effort to study those flaws and see if they can correct them before deciding to throw the whole thing out and go back to the way it was before the ACA. It’s not as though our health care costs were under control before Obamacare was created. Health care costs, and therefore health insurance premiums, have risen nearly every year that I’ve had health insurance, sometimes in double digits, and health care costs were often a burden on industry as well as individuals and families, leading to bankruptcies.

There are many complex reasons for the high cost of health care in America. The unpleasant truth is that there will always be those who have medical costs they can’t afford, and few of us can be sure that we will never have to face such costs.

The ACA was intended to control those costs while, at the same time, enabling all Americans to insure themselves against financial ruin due to a serious illness or a major accident. Personally, I believe that the government has a role to play in achieving those results, whether by fixing the shortcomings of the ACA or through a new system.

Unfortunately, it appears that our leaders won’t be doing that anytime soon. We elected a president who said recently, “No one knew health care could be so complicated,” and he bailed out of any effort to change things. That means it’s up to Congress, and Speaker Ryan doesn’t even know why he couldn’t get a majority to approve his plan.

I find that disturbing, but that’s the situation we elected last November.