Health Care: All for the Best

In Judaism, we have an expression that is equivalent to "It's all for the best": Gahm zu l'tovah – this, too, is for the good.

Nowadays, with the 24-hour news cycle, every story, big or small, is made to rival the Hindenburg Disaster, Pearl Harbor, and First Manassas.

When I watch news, I watch Fox.  I have not watched CNN, MSNBC, or any source other than Fox since the November election.  Literally.

Every three minutes, Fox does that thing with the chime: "This is a Fox News alert."

That also is how they begin every, every program (except for O'Reilly).

The reality is that very few things really are as urgent or as concerning as reported at that moment.  They do not merit a loud chime.

With health care, if the bill is wrong or flawed, it is better that the Republicans not pass it on Trump's 64th day.  The GOP gave it a shot.  I have no problem with their having done health care before taxes.  I avoid being a "Monday Morning Quarterback" because I myself have been "in the arena" enough times to know that every loss or setback will be second-guessed ("I told you so!"), while every success is met with "I was behind you a hundred percent.  I am glad you listened to my idea – I was going to share it with you but forgot to."

Health care reform is tough.  It requires taking away free stuff from people.  That is very hard and unpopular to do.  In Obamacare, there are so many moving parts that any restructuring effort entailed getting into the muck and mire.  Now Paul Ryan has presented his "balanced" bill, gotten the necessary feedback, seen what can be bent, what is insoluble, and a new, better bill can be structured for next time. 

There was a bunch of great stuff in the initial effort: end funding to Planned Parenthood as long as they do abortions.  Force Medicaid recipients, who, unlike the elderly and disabled on Medicaid, really are quite able-bodied and capable of doing so, to go out and get a job.  Stop scaring companies with 49 employees so they no longer have to fear hiring a fiftieth employee and no longer feel compelled to force full-time workers into 29-hour-a-week jobs.  Lots of great stuff.  Phase 3 of Ryan's package would have included allowing associations to bundle individuals into much lower cost group plans, to bring down premiums because large groups can economically absorb pre-existing conditions.  It would have allowed for interstate competition in health insurance, provided for much-needed tort reform in medical malpractice litigation, and required more sophisticated bidding and negotiating to bring down drug costs.  Lots of great stuff.  Meanwhile, Phase 2 of the reform plan would have expunged scores of costly and deleterious Obama regulations.  All great stuff.

But the bill had flaws.  Conservatives have our concerns; liberals have theirs.  These flaws in the first iteration of repealing and replacing Obamacare can be fixed, but they need more time and more patient negotiating.  Ryan now understands where the unmovable barriers are, where the negotiators are not bluffing.  And complicating all of it is the sheer idiocy of the arcane Senate rules that require 60 votes unless they do it via the crazy "reconciliation" rules that were refined by a former Ku Klux Klansman, the Hon. Cyclops Robert W. Byrd.  

There is nothing wrong with walking away from a negotiation and saying, "That's it.  I'm outta here."  In the 24-hour news cycle, it sounds like Pearl Harbor or the British burning down the White House.

But that is how I used to buy a car, before the internet offered better ways.  After half a day of negotiating, and the salesperson passing little love notes back and forth with the office manager, I would walk out.  Sometimes I never came back; sometimes I did, and they offered a better deal.

Back in 1987, I went to buy a Nissan Sentra at a famous Southern California dealership.  Two family members accompanied me.  They told me: "This dealer is amazing.  No one ever leaves without him selling the car.  He is mesmerizing."  He and I negotiated three hours until midnight that Labor Day.  He would not agree to make a concession on which I insisted.  So, after three grueling hours, I just walked out.  My family members could not believe it: "No one ever walks out on this guy without buying a car."  The next day, I bought a Honda Accord from a guy named Willie Wong at Woodland Hills Honda.

Over the next thirty years, I have bought six more cars – all Accords.  I love the Accord.  Nissan lost me that Labor Day.

If it were the 24-hour news cycle, they would be chiming: "Fox News alert – Man leaves without buying Nissan.  How will he ever get to work again?"  Well, no one buys a car with a "Fox News alert" chiming in his head every three minutes.  Indeed, don't we all wish Obama and Kerry knew how to walk away from Iran when negotiating that awful sucker deal?  They would have gotten back the hostages, would not have had to send the cash in planes – and maybe even cut a half-decent deal.

It's OK to walk away from a deal.  That is what Trump did...and good for him and Ryan.

Obamacare will implode of its own.  The Democrats put lots of sugar and candy into Obamacare's first years, with built in time bombs to explode as of 2017, once Obama was safely out of office, golfing in Hawaii or dancing the salsa in Cuba.  Then the explosions would start.  New unpopular features would begin.  Certain government funding would be withdrawn.  The idea was to get the CBO to score the Obamacare favorably for its first year or two, to get it through Congress, with the piper being paid later.  Most average people – and, after all, aren't most people average and mediocre by definition? – have no clue on Earth as to what is going on.

But those in the know realize that even more insurers now will be pulling out of Obamacare as subsidies expire, so even fewer insurance options will remain, and crazy-high five-figure deductibles will set in that make the policies virtually worthless.  More people will drop out as they realize that all their medical care is out of pocket anyway with such high deductibles, so why pay meaningless premiums?  In addition, because no one now will be penalized dropping out, the floodgates will open like the Exodus from Egypt.  "Egypt me!" they will yell.  As even more drop out, with even fewer paying premiums, the premiums for those remaining in Obamacare will shoot even higher to compensate the insurers for their losses, resulting in even more people dropping out and therefore in even more insurers pulling out.  Hence, the references to Obamacare now entering a "death spiral."

So here is what will happen these next few days: the media will make it a bad weekend for the GOP.  Pearl Harbor.  Cold Harbor.  Shiloh.  The death of Ned Stark.  Trump has lost his magic as the deal-maker.  Ryan is getting sun tan treatments to look like John Boehner, as he faces ouster.  All kinds of overheated exaggeration.

Then comes Monday, a new week.  Some idiot will accuse Manafort of plotting with Trump and Putin to win the election.  More revelations about Flynn and the Turks.  Trump will tweet something insane that absorbs a day or two of news.  And then Judge Gorsuch will get approved on party lines by the Senate Judiciary Committee, and the news focus will turn to how Trump got his judicial nominee through, and will the Democrats filibuster, and will the GOP go to the nuclear option, and no one will remember health care.  Then a great tax bill will emerge, and it will pass successfully because every Republican in Congress knows that they cannot let any more Trump initiatives slip.  The stock market will jump several hundred points.  And maybe there will be some news about infrastructure and the Big Beautiful Wall.  And then, next autumn or early next year, back to a better repeal-and-replace of Obamacare as the thing really blows up, and as Congress has to act.

And the angelic chimes will ring: "This is a Fox News alert."

Rabbi Dov Fischer, an attorney and adjunct professor of law, is a senior rabbinic fellow at the Coalition for Jewish Values, congregational rabbi of Young Israel of Orange County, California, and holds prominent leadership roles in several national rabbinic and other Jewish organizations.  He has been chief articles editor of UCLA Law Review, clerked for the Hon. Danny J. Boggs in the United States Court of Appeals for the Sixth Circuit and served for most of the past decade on the Executive Committee of the Rabbinical Council of America.  His writings have appeared in The Weekly Standard, National Review, Wall Street Journal, Los Angeles Times, Jerusalem Post, American Thinker, Frontpage Magazine, and Israel National News.  Other of his writings are collected at www.rabbidov.com.

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