EDITORIAL: Bettering health care reform is far more work than repealing it

April 07--Despite pronouncements a week ago that the GOP's eight-year war on the Affordable Care Act was over for now, efforts have continued, both at the Capitol and the White House.

That could be a blessing, but thus far, it isn't.

It could be, if those efforts stemmed from the realization that the House leadership's fatally flawed American Health Care Act would have taken all the wrong steps in reforming our health care system, benefiting only those who can already afford health services at the expense of those who need care the most. It could be, if that realization led lawmakers and the Trump administration to seek cooperation across the aisle. It could be, if President Trump and House Speaker Paul Ryan cared a whit about assuring access to actual health care, rather than scoring what they perceive as a political win.

In that case, perhaps continuing negotiations would be focused on how health care is paid for in our nation; how to ensure those who have the most difficulty accessing care -- including those struggling with opioid addiction and mental health issues -- can gain such access; and how to bring down increasingly outrageous drug prices.

But that's not the case here. Instead, it's blatantly apparent the effort is continuing only because the president is unable to accept being called a loser publicly and because Ryan is afraid of losing the opportunity of having both chambers of Congress and the White House in the hands of conservatives.

That was made clear when Ryan breathlessly warned that if House Republicans opposed to the AHCA didn't surrender on this vitally important issue, Trump might -- gasp! -- actually attempt to cooperate with Democrats to reform health care. Thus, instead of efforts to create the best reform bill possible, we now have the White House and speaker working frantically to cut political deals so as to entice enough votes in the House.

Earlier this week, the plan was to offer state governments the ability to seek waivers that would exempt them from the core tenets of Obamacare, the so-called "essential health benefits." You know, things like covering mental health, substance-abuse treatment, maternity care and prescription drugs. Or preventing insurers from charging those who are really sick more. In other words, the plan was to appeal to the House tea-party wing, also known as the Freedom Caucus, by removing the "health" and "care" parts of health care reform, leaving only tax benefits for the wealthy and higher premiums for insurers.

But that plan apparently wouldn't appease enough GOP moderates, who are worried about their 2018 re-election if they pull health care from their constituents. So the idea of "high-risk pools" was floated mid-week, a concept conservatives pitch as providing care to the very sick, although it would actually just drive up their costs compared to having mandated coverage.

But even if they buy enough House votes to temporarily claim victory, none of those deals is likely to satisfy a majority in the Senate. Perhaps that's OK with Ryan and Trump. They could then claim, falsely, that they did their job, but the Senate failed to do its. Sadly, such political gamesmanship and blame-shifting has become commonplace in Washington.

The worst of it is that the Affordable Care Act, while it has made things better for millions of Americans, is not a perfect solution. It actually should be looked at and improved, and if it's done right, few outside the Oval Office will care whose name is attached.

The reason Ryan's attempt to strike down Obamacare failed is the same one that led to the flaws in that original reform: It was rushed. Republicans received no small amount of ridicule when their bill failed because they've been assailing Obamacare for eight years, yet didn't have a real reform plan when the time came. No surprise there. Despite Trump's oblivious assertion last month that "No one knew how complicated health care was," pretty much everyone paying any attention knows how complicated health care is. It can't be reformed in weeks.

And it surely can't be solved through the use of carrots and sticks on House members.

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