Obamacare and Choice

There are 3,142 counties and equivalents (Louisiana has parishes, Alaska has boroughs, three States each have an independent city, Virginia has 38 of them, and State of Rhode Island and Providence Plantations does things entirely differently) in the US.

The Centers for Medicare and Medicaid Services expects that 40 of those counties will have no health care coverage plan providers at all in 2018, and 1,332 of those counties—over 40% of them—will have only one such provider.

Not to put too fine a point on the matter, but this is not choice.  This also drives home the lie of “If you like your doctor, you can keep your doctor; if you like your insurance plan, you can keep your insurance plan.”

Obamacare’s implosion is in full swing, it’s happening rapidly, and Republicans are fiddling.  They can bleat that it’s all Progressive-Democrats’ fault, that the Progressive-Democratic Party owns Obamacare to their heart’s content.  It’s irrelevant.  The Republican Party has been running on repeal and replace for the last four election cycles, and they now have majorities in both houses of Congress, and they have the White House.  The Republicans own repeal and replace—and they own the failure to make even the first syllable of progress toward that worthy end.

Timid Republicans need to find their courage and get on with the business.  Along these lines, others who demand that it all be done at once—both right damn now and in a single bill—need to recall the lessons of Obamacare as a single, all-at-once, almost right damn now bill, and they need to keep in mind political realities: Republicans in the Senate don’t have the filibuster-proof majority the Progressive-Democrats had for most of the time they were putting together their bill.

Repeal and replace can’t, won’t, and shouldn’t happen in a single bill.  It’ll need to occur as a series of bills, although those bills need to be passed in quick succession as politics go: over the course of a couple of Congressional sessions, or at most over two Congresses.

Senators Susan Collins (R, ME) and John McCain (R, AZ) are desperate to return to “regular order,” to negotiate with Progressive-Democrats and to hold hearings.  Fine.  Do that.  Those hearings need not take longer than a couple of weeks—especially if the Senate (read: Republicans) get rid of the ridiculous 2-hour per day limit on hearings—and the negotiations can be done similarly quickly, particularly since the Progressive-Democrats have shown they won’t seriously negotiate.

But get after it.  Republicans need to stop dithering, stop playing with their…fiddles…and get on with the business.  They have their own choice to make regarding their place in Government and in the nation.

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