25 March 2017
The system works, or does it?
Can we stop now with the talk about Donald Trump being or becoming a dictator? He's just suffered one of the most embarrassing legislative defeats in the modern history of the presidency at the hands of his own party. After promising during his campaign to repeal the Affordable Care Act as soon as possible, and after more recently threatening to primary any Republican representatives who dared vote against the "repeal and replace" bill in the lower house, the President ordered Speaker Ryan to surrender by withdrawing the bill. He has learned what every President learns, which is that our political system today virtually guarantees re-election to any congressman who wants it, regardless of what a President who is also de facto party leader wants him to do or not do. Trump's fans hoped, and many of his detractors feared that his legendary deal-making prowess or his exaggerated bullying tendencies would override this dynamic, but until he can demonstrate that he can successfully primary defiant Republican incumbents those Republicans have no reason not to dare him to try. I suspect, however, that the President won't carry this grudge into next year, especially if the threat only makes dissident Republicans in the center and on the far right more defiant. Whatever else happens in the next two years, it is now proven that this Republican congress will not simply rubber-stamp the Republican President. Hooray! Meanwhile, "Obamacare," with all its flaws, remains in place, presumably unamended, for what Ryan calls the foreseeable future. Trump's idea now seems to be to let the ACA "explode," as he expects it to, so that Democrats will still be blamed for rising premiums and other problems until popular demand for change proves irresistible to quibbling Republicans. This doesn't seem like the ideal way to reform the health insurance business, but it's probably the inevitable way so long as an admirable idea of providing insurance for everyone is yoked to ideologies and vested interests and made an object of partisan competition. So long as universal health coverage means more costs than benefits for some people and offends others' notions of deserved suffering, the politics of health care will not be easy, even (or especially) for alleged authoritarians like President Trump.