The Moon Shot Of RyanCare

By

Leonard Zwelling

Now, can we get back to real business? You know, like whether or not the Trumpians colluded with the Russians or whether Michael Flynn was trying to abduct an American citizen and send him to Turkey. Surely this can be tweeted about now.

The law of the four P’s of Washington has triumphed once again when it comes to the variables that affect the success of legislation.

The four P’s are policy, process, politics and personality, in ascending order of importance. The failure of the Republican-invented American Health Care Act to undo ObamaCare is proof positive that all P’s matter and that the order is correct.

Let’s start with the Policy.

It was awful. It would have denied many millions of Americans health insurance and given a huge tax break to those least needing one. It was GOP at its core. It was heartless, muddleheaded, and unresponsive to what the American people really want (health care for all for free—not gonna happen despite what Bernie says).

You would think that the GOP would have learned from the Dems’ mess of the ACA in 2009-2010. You cannot legislate successfully with only the votes of one party. That’s a doomed process. They tried it anyway and couldn’t pull it off despite having done so in the House over 50 times before when Obama was president and there was no chance that their flawed bill would become law. The threat of success was obviously too much.

Furthermore, the GOP constructed a bill that reduced the deficit (of course, it covered fewer poor people) so they could get it past the Senate using the process called reconciliation and only 51 votes. That didn’t mean the bill smelled better. It reeked.

The politics was also against the GOP. Extreme conservatives saw the Ryan Plan as ObamaCare lite (they were right as so much of ObamaCare was maintained in the Ryan Plan) and the moderate Republicans, particularly ones from Red States that expanded Medicaid, saw their older and poorer constituency losing coverage. The governors of the states were screaming against the bill as were the docs and the hospitals and the drug companies. Politically this was dead on arrival, even in the House and certainly so in the Senate.

As for the personalities, you have to admit this was an awful cast of characters. President Trump was a cheerleader for a bill he clearly neither understood nor read. (The bill was longer than 140 characters in length.) He had no idea what was in it and likely wouldn’t have even if it had passed. He just wanted a win.

The next tweet will be:

“No health reform. @Ryan’s fault. Not my idea. Sad.”

Mr. Ryan is a true believer but like his predecessor Mr. Boehner, he is learning the Freedom Caucus of right wing zealots doesn’t have to care about being primaried from the right. Its members vote the way they want.

You can’t beat this for drama, but it is really poor governance.

It kind of reminds me of the way Dr. DePinho was going to cure cancer in five years with his moon shots.

Naiveté can really ruin your day.

Leonard Zwelling