Who's The Boss?

The most recent effort to strip the country of the Affordable Care Act is over and TrumpCare or The Health Care for America has failed to take it's place. That is a blessing. What is not a blessing is that it was largely defeated by reactionary conservatives who thought that it didn't cut enough health care from poor people. We can gloat temporarily in that the Great Deal Maker couldn't put the deal together but we can't afford to become lackadaisical. They will be back and a little smarter next time. One of the things we can rejoice in is that the President discovered that you can't run the United States the same way he runs a business. There are people in Congress just as ruthless as he is. I honestly don't know what to expect out of this guy except that it won't be anything that I would approve of.

So the Affordable Care Act remains the law of the land despite concerted efforts to cut it to pieces in a profane display of disregard for the least of us. Those miscreants can still blame Barack Obama for the whole thing but he should be highly regarded for having the vision and the will to push forward when all of his advisors told him to pull back. He had the wisdom to know he had to do it early while

he still had the political capital to pull it off and as the Trump administration said in surprise, “this stuff is hard.” Yes, President Obama and those who did the heavy lifting discovered that in the two years spent negotiating with various interests and finding what kind of compromises would have to be accepted. That is the art of legislation, something that most of our legislators have decided to disdain. Somewhere John Boehnor is sipping a scotch and chuckling. Well, so is Barack Obama and if I were a drinking man I'd like to be with them.

The Congressmen and Congresswomen went home and found a lot of angry people who hadn't realized that the Affordable Care Act and ObamaCare were the same thing. They wised up when they

started hearing they could lose their health care. One woman who voted for Mr. Trump cried that she didn't think he would really do that. What can I say? He said he would. He also said that everyone would have health care and it would be better, way better, incredible in fact.

Having said all of that does not mean that I think the ACA is perfect. Far from it but there are only a few things that need fixing. Cost increases, choice of insurers and accessibility for those who aren't insured. The original bill had provisions in it to deal with these issues but the GOP went to court and got them thrown out by a conservative court. They had to be aware of the difficulties that would create but that was not their focus. Their focus was to destroy the ACA. There was a provision that tied Medicaid payments to the states to their expansion under the ACA. That would have made the ACA evenly applied coast to coast. Gone. There was a provision to reimburse insurance companies for unexpected costs incurred while initiating coverage due to the increased participation. This would have reduced the reasons for insurance companies withdrawing from markets due to unexpected losses. Then there was the Public Option which was designed to create a competitive environment in low participation areas. Gone. These provisions, when thrown out, have created every one of the problems that are foremost in most people's minds. Fix these and it fixes the Affordable Care Act. No need to throw the baby out with the bath water.

All so simple but that is not what the ideology championed by the GOP is designed for. It is designed for every one to pull himself or herself up by the bootstraps and become sufficiently prosperous to fork out at least 6K per year to buy insurance. I don't know about others but I found that impossible to do and went without insurance for almost 30 years. Call it luck if you will but I reached Medicare before the ACA went into effect. I actually paid for it out of pocket for 3 years. Now there are families making 50K per year who find insurance premiums to be out of reach even with the subsidies. That is outrageous but those provisions thrown out would have gone a long ways to allay that. But we argued all that stuff 5 years ago.

The election stunned most people however there is one guy to whom I own $100 on a bet I made on the election that I was not a bit afraid to make. But since then some people have awakened that could have made a difference and have found out that the President may have been using alternative facts when he said everyone would be covered. They are making a lot of noise but I would caution people to not become too comfortable. Yes, there have been some angry people at the town hall meetings. Solution:don't hold town halls. Yes, there have been a lot of phone calls. Solution: stop taking phone calls. Yes, there have been millions of cards and letters. To my knowledge the legislators have not figured out how to stop the U.S. Postal Service yet. They're trying.

My Take is keep your powder dry. These Congressmen and Congresswomen are very smart about who they think will show up at the polls. They know that if they can keep the publicity down their constituency will send them back again. The only thing that will make a difference is physically

showing up in the streets with the cameras rolling. That is the only thing that will cause them to alter their allegiance to their contributors. They may tell you they work for you but they won't do it until you show them who is the boss.