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The American Voice Institute of Public Policy Blogs the Issues!

Monday, March 27, 2017

The failure of Ryancare is a blessing in disguise!

  By Joel P. Rutkowski, Ph.D., President

Trump must assemble a team of policy experts

For President Donald J. Trump to make his campaign agenda a reality, he must assemble a team of policy experts in the White House that he trusts to develop solutions to the issues that concern the American people the most.   Unfortunately, he deferred policy leadership to Speaker of the House Paul Ryan (R-Wisconsin).  It was reported that U.S. Representative of Texas Louis Gohmert (R) said GOP leadership in the House of Representatives wrote their bill in secret, a mistake he said that has been repeated time and again, and then tried to force it on lawmakers. Establishment Republicans have campaigned since 2009 that they would repeal and replace Obamacare.  These individuals with the support of lobbyists know that this message would win elections and put Paul Ryan in as speaker.    

Unfortunately, Trump Trusted Ryan 

During the primaries, Speaker of the House Paul Ryan did not support Donald J. Trump, and during the Presidential election did everything he could to damage his campaign against Hillary Clinton.  President Trump must realize that establishment Republicans like Ryan despise the President as much as Democrats do.  Mr. Trump should be wary at all times since these individuals do not have his best interest at hand.   Foolishly, President Trump did everything he could too support Ryancare. He even threatened the Freedom Caucus members that if they did not vote for Ryancare that he would campaign against them during the primaries so they would not get reelected.  And the “take-it-or- leave- it” tone of Speaker Ryan and the President made situations even worse.   President Trump was elected to put the Republican Party back on track addressing issues that concern the American people, not lobbyists and special interests like Obamacare does.  

 A difficult issue

Health care policy is a very difficult issue.  Costs are going to go up unless Congress enacts drastic reforms.  And whatever discontent arises over costs or coverage, the American public will blame whoever passed the last piece of legislation to cause this.  Unfortunately, governmental solutions like Obamacare and Ryancare are a one-size-fits-all scenario.  These social engineering schemes that have created a tangle web of dependencies must be compensated for or offset somewhere else which is contrary to free-market reforms.  

Democrats crow as Americans suffer 

Obamacare is in a death spiral and heading for an eventual collapse.  American are paying 44.5 to 68 percent more in premiums owing just to Title I regulation when accounting for gender, age, and the relative proportions of all those groups.  Yet Democrats are crowing at the failure of Ryancare while providing no solution to the current health care crisis other than obstruction.  It was reported that a Democratic National Committee (DNC) Rapid Response email titled “Hands off Obamcare!” stated “This is a huge victory ─ grassroots Democrats like you made hundreds of thousands of calls and signed petitions to oppose this bill, and House Republicans buckled under the pressure.”    This just shows Democrats care more about politics than the American people that are hurting economically as well as healthwise from Obamacare.    Americans must never forget that it was the Democrats led by former President Barack Obama that created this health care nightmare that is destroying America's health care system. 

Final Thoughts 

The Freedom Caucus should not be chastised as it is by the media, establishment Republicans, as well as others for stopping Ryancare.  They should be applauded and hailed for their efforts.   President Donald J Trump was ill-advised in taking up health care reform as his first major policy issue of his Presidency.   After so many years of slow growth and stagnant wages created by Obamanomics, his first priority should be to reinvigorate the economy.   The failure of Ryancare is a blessing in disguise.  Overhauling one-sixth of the American economy is difficult and complex and should not be rushed as Speaker of the House Ryan and President Trump tried to do. There is plenty of time for Congress to tackle health care reform.  It is a difficult challenge to repeal Obamacare entitlements, to lower costs enough that will entice the private-sector, and to provide alternative health care plans.  If Ryancare would have passed the Congress and signed into law by the President Trump, the Republicans would have been on the receivership of the political fallout that would have resulted because it would have resulted in an even more rapid death spiral than Obamacare.  Ryancare maintained the existing and pricey regulations that required insurance companies to indiscriminately cover individuals with pre-existing conditions, while striking down the individual mandate that was supposed to cover those costs by pressuring relatively inexpensive young people onto the rolls. The problem would only get worse without the mandate because millennials would continue to opt out.  Also, lower income white voters played a crucial role in electing Donald J. Trump, yet Ryancare would have been worse than Obamacare for this demographic group.   

President Trump learned that the art of the deal in the business world is totally different from the art of the deal in the political world. The President became involved in the legislative process too early.   He should have allowed Ryancare to go through the legislative process.  For example, if the bill passed the House of Representatives it would go next to the Senate for its amendments, and if it passed the Senate would then go to the House-Senate conference committee to resolve the difference.  Once out of committee the President should have a team of health care policy experts in the White House that he trusts to thoroughly review the legislation giving him a complete analysis of the legislation, their thoughts and recommendations.  After this he should than determine if he wants to support or oppose the bill.  Unfortunately, the President appeared too anxious for a big legislative win without knowing totally what was in the bill.  When crafting a bill to replace Obamacare, free-market and limited-government principles should be the focus of the legislation.  The strategy to replace Obamacare is totally doomed from the start in that it is codependent on too many different factions of Congress to succeed.  Currently, it is almost impossible to get enough votes to overcome procedural hurdles to fully replace Obamacare.  Instead the Republicans should follow an incremental approach of proposing individual bills that address specific policies that have made health too expensive for everyone, then have a debate on the bill and vote on it.  For example, individual bills could allow for competition of insurance companies across state lines, allow more individuals to purchase health savings accounts/flexible spending accounts (HSAs/FSAs), tort/malpractice reform, incentives for states to embrace litigation reform and end defensive medicine, for physicians that offer pro bono services to the poor tax and red-tape relief, and the freedom to create risk pools for mutual insurance purposes for any association of citizens.   

For President Trump to be successful in transforming America, he must constantly put emphasis on doing the unexpected and pursuing an indirect approach.  In 1960, spending on health care was five percent of gross domestic product (GDP) and by 2016 it more than tripled to 17.8 percent.  Furthermore, by 2025 it is feared it will be 20 percent a 400 percent increase in 65 years.  To fix the current healthcare system problems, it is time for Congress to seriously consider getting Washington out of the health care business and return that power to the states.  For any health care reform to be successful it must let market principles influence the insurance companies to provide insurance plans that empower consumers and their health care needs. Unfortunately, Obamacare and Ryancare forces these companies to continue to look to the government to regulate and subsidize.  Successful health care reform will reduce the rising cost of insurance premiums and escalating deductibles.


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