July 18, 2017
Lessons from the Republican Health Care Disaster
Republicans said they wanted to repeal Obamacare in the worst way—and they did.
In 2010 Democrats pushed through one of the most unpopular bills in recent memory.
In 2017 Republicans took that same bill, the Affordable Care Act—which (1) had become even more unpopular and (2) helped Republicans taking over the House, then the Senate and then the White House—and completely botched the effort to repeal it.
There are lessons to be learned from this political disaster.
Lesson 1: When you have a mandate with momentum, act on it. Bill Clinton won the 1992 presidential election in part by promising sweeping health care reform. After inauguration, he set up a committee headed by Hillary that took six months to craft reform legislation.
During those months, Clinton Care opposition forces began turning the tide of opinion. The momentum faded, and legislation that had seemed inevitable eventually became inconceivable.
Barack Obama learned from those mistakes. He outlined some basic principles he wanted and handed the task to the Democratic-led Congress, which passed Obamacare in a squeaker.
Republicans had planned to capitalize on the momentum in 2017 and strike early by immediately passing the Obamacare repeal legislation that had already passed the House and Senate in 2015, but which Obama vetoed.
But Senator Rand Paul and a few others objected. They proposed doing repeal and replace at the same time. The only problem was Republicans didn’t have a replacement plan.
In the several weeks it took to craft a bill, Democrats and the media geared up with a misinformation campaign that began to turn the tide of opinion.
Lesson 2: When you say you want to replace legislation, have a replacement plan. For six years Republicans said they wanted to replace Obamacare but never created a bill. At least House Speaker Paul Ryan released a replacement outline in 2016, but it wasn’t vetted and it wasn’t in legislative language.
Even after Republicans woke up on November 9 and realized they could fulfill their repeal and replace promise, they didn’t start crafting a replacement plan. When they finally started in the House, they had to rush it through, in secret, avoiding the normal committee process where you reach consensus and compromise.
As for the Senate, Republicans apparently waited until after the House passed its bill to try and rush through its own secretly crafted version, again bypassing the normal process intended to achieve consensus and compromise.
Lesson #3. Learn how to market an idea. Democrats take a complicated idea and make it simple—“If you like your health plan, you can keep your health plan”—whether it’s true or not.
Republicans tend to take a simple idea and make it complicated, such that even they don’t understand what they want to do. Republicans just don’t have the marketing gene, but at least they could hire someone to do that for them.
Yes, there are lessons to be learned from the Republican health care disaster, but will Republicans learn them?