HEALTH CARE: STILL NO MIDDLE GROUND….APPARENTLY

PERSPECTIVE FROM THE 19TH HOLE: This is the title I chose for my personal blog, which is meant to give me an outlet for one of my favorite crafts – writing – plus use an image from my favorite sport, golf. Out of college, my first job was as a reporter for the Daily Astorian in Astoria, Oregon, and I went on from there to practice writing in all of my professional positions, including as a Congressional press secretary in Washington, D.C., an Oregon state government manager in Salem and Portland, press secretary for Oregon’s last Republican governor (Vic Atiyeh), and a private sector lobbyist. This blog also allows me to link another favorite pastime – politics and the art of developing public policy – to what I write.

Last night, I watched House Speaker Paul Ryan hold a town hall-type meeting with journalists to talk and answer questions about the Republican health care plan.

To say he was competent would be an understatement. He was able easily to discuss all aspects of the plan, including answering probing questions from the media without a teleprompter. He contended that the current process would be the last and best chance to do what Republicans had promised for years, which is to repeal and replace ObamaCare.

When Barack Obama took office as president more than eight years ago, he arrived at the White House with a pledge to overturn gridlock in Washington, D.C. and lead an effort to find compromise on pressing public policy issues.

Despite that pledge, over his eight years, he did just the reverse.

The best illustration was his personally proclaimed signature health care reform “achievement,” which came to be known, with his eventual blessing, as “ObamaCare.” It was passed with only Democrat votes in a huge indication of what illustrated his intention to work around Republicans, not with them.

Today, the legacy of Obama, no middle ground, is taking root in the new health care debate. Given all of the opposition over the last few days, it appears Republicans may not be able to get their act together sufficiently to undo ObamaCare and enact a new Health Care for Americans program, despite Ryan’s best and compelling rhetoric in defending of what his leadership has proposed.

Further, it also would appear that, even if Republicans coalesce around a plan, they will not get Democrat support, so we’ll be left at best with another “one side of the aisle action.”

As someone involved in politics and public policy for nearly 40 years, that makes me sick….for at least three reasons.

First, the current swirl indicates that we, as both Americans and those who represent us, have no ability to find what I call the smart middle ground. We like to contend for our position, to fight more than agree.

Second, it tends to illustrate that very good legislators – Speaker Ryan and Oregon’s Greg Walden can do good work only to be pilloried by colleagues more interested in sound bites that solid policy.

Third, it indicates that the likely result is continued movement toward a single payer health care system, a government-run and government-financed program. And, surely know this, if a single payer system emerges, it is you and I who will be paying for it with higher taxes.

The current reform proposal, crafted by three leading Republicans – Oregon’s own Walden, Kevin Brady from Texas and House Speaker Ryan – debuted the other day to immediate negative reactions from many quarters.   But, to the credit of the three, the intention was not to impose a bill on everyone as a done deal. Rather, they brought the bill forward in two committees, one chaired by Walden and the other by Brady.

Ryan emphasized that the 143-page document, in contrast to ObamaCare’s 2,000 pages, would be reviewed by four committees before it came to the House floor. He also emphasized that the bill was only one part of a three-part strategy, a second being administrative actions by House and Human Secretary Tom Price to reduce health care costs, and another bill that would deal with issues that could not be included in the “reconciliation process.”

Under “reconciliation,” admittedly an arcane rule, a bill cannot be filibustered by senators. They have to vote it up or down.

All of this was a far cry from what happened early in Obama’s tenure when the health care act, in its 2,000 pages, emerged overnight and moved quickly toward votes on the floors of the House and the Senate. It passed without one Republican vote.

And, further, in an incredible statement if you think about it, then-House Speaker Nancy Pelosi said she had not even read the bill when she voted for it and asked all of her colleagues to do the same.

As I wrote in a previous post, there is a lot at stake here. For one thing, Republican credibility as those in charge in Washington, D.C. rides on the outcome, and, if majority Republicans don’t rally behind the bill, their tenure in leadership will start on a sour note. And, as Speaker Ryan noted, they may not have another chance to deal with ObamaCare.

Further, if the House Republican bill fails, it becomes even more likely that we’ll see what may have been the goal of many interests all along, especially Democrats — a government-run and government-financed single payer system.

To be sure, government has a clear role in health care. Witness Medicaid and Medicare. But, if we devolve to an entire government-run system, we’ll be sorry for years. The marketplace will have no effect on health care decisions and, sooner than you can say TrumpCare or ObamaCare, the government will be telling you who your physician will be – and you’ll be paying for it.

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