Health care policy is not really a political story. It is an insurance story. It just looks like a political story.
For all its political aspects, health care policy exists within actuarial reality. It cannot escape. Therefore, the only health policy writer I read regularly is Bob Laszewski. He's an insurance lobbyist. He said Obamacare wouldn't work in a sustainable way when they passed it. He explained why in plain English. He's been right about every setback or success the policy has had for more than seven years running. He is not a prophet or a guru. He is just a guy who reads actuarial tables so the rest of us do not have to.
And here is what he says about the GOP plan. This is in the first sentence of Tuesday's entry in his blog:
"It won't work."
He then explains why in plain English.
By all means, stop reading this and go read the March 7 blog entry at healthpolicyandmarket.blogspot.com. I would stop this column right there, but I have space to fill.
Laszewski makes a very shrewd political point in his blog. The Republicans so far are making the same mistake the Democrats made passing Obamacare. They are in power, and trying to come up with a bill their base wants. "That would make this Republican scheme just as politically unsustainable -- half the country will hate it -- just a different half," he wrote.
So here is my contribution to my own column today: The GOP is in a position of political dominance unseen in modern times. They have the White House. They have the Congress. They will very soon have the Supreme Court. They have 33 governorships and a degree of domination in state Legislatures unseen for their party since the end of the 1920s.
If they cannot take a wider view and come up with a workable plan, then try to blame Democrats -- or the media, or liberal elites, or anybody else -- there is no grounds whatsoever to believe them. Things simply do not get any better than this for any political party, ever.
On a more personal note, I have to admit to some bipartisan frustration. I wish a debate over what our troops and diplomats' mission should be in Southwest Asia and Africa in general and the Middle East in particular got one one-thousandth of the attention health care is now going to get -- again.
There will be no tax cuts or a balanced budget or serious progress in reducing the national debt -- or single-payer health care or paid-for college tuition for everyone, either -- as long as there is a war on.
I am no peacenik. I think at least some of the fights we are in need to be won. I also think a lot of people have died and are dying overseas in chaos we either helped create or did not do enough to curb or relieve. But those issues will never get the primacy they deserve, it seems. So back to health care, today's topic -- which will likely be tomorrow's topic every day for the rest of my career and beyond.
Of all things, the health care debate reminds me of the energy crisis of the 1970s. Americans were told then that the age of cheap gas was over. They were going to have to conserve and change their habits. Some did, but most refused. Now we are are being told relatively cheap health care with lots of choice is not happening. We need to diet, exercise and take responsibility for our own health. That is not going well either.
I thought Perry Bacon Jr. of the Fivethirtyeight website made a good point. Then Nate Silver, founder of the same site, made a better one.
Bacon pointed out it is really hard to write a bill that pleases the conservative lobby Heritage Action, moderates like Sen. Susan Collins, pragmatists like Ohio Gov. John Kasich and zealots like the House Freedom Caucus. Then Silver asked, "But is it hard to write a bill that pleases at least one of Heritage, Susan Collins, John Kasich, Rand Paul, National Review, the AARP and the House Freedom Caucus? Absolutely nobody liked this thing."
There is an old saying in journalism that if none of the people involved like your story, you probably got it about right. That saying does not apply to any other field.
Commentary on 03/11/2017