There is a scene in The Grifters where a pair of con artists try to persuade their mark that they have developed a computerized system to beat the stock market. When the skeptical victim says, “I don’t see how you can do it,” the con artist bursts out, “Machines! Machines, Gloster! I have got a whole room full of machines back here. Y’wanna see it?” He opens the door to a back room, which in fact is empty, begging the mark to get up and inspect for himself, knowing he won’t bother.
This has been the Republican messaging strategy on health care for more than ten years now. If Democrats would just abandon Obamacare, Republicans would come in and implement a better, cheaper plan. Just wait! It’s ready to go! Give us the chance!
President Trump, having watched many hours of Fox News, apparently believed this promise that he could eliminate Obamacare and easily replace it with something better for everybody, only to discover that health care is complicated. He has been periodically promising to produce his replacement plan in two weeks.
However, Ruth Bader Ginsburg’s death has turned that perpetually unmet promise into an especially acute liability. Trump’s administration is filing a lawsuit to rule Obamacare unconstitutional. This would eliminate all protections for patients with preexisting conditions in the individual market, which would return to the pre-Obama era in which insurance was sold on the basis of health and unaffordable to anybody expected to require expensive medical treatment. The strong chance that he will replace a liberal with an archconservative makes that lawsuit, which even conservative legal experts have mocked, suddenly very plausible.
The Washington Post reports on Trump’s recent deliberations, or the Trump version of deliberations, on the issue. On the one hand, Trump “has berated health-care officials, saying that the issue is hurting him politically.” However, many paragraphs later, the story notes that the president “does not have a deep understanding of the health-care system, according to current and former advisers, and the topic does not animate him.”
Angry and ignorant is never a great combination of traits for solving difficult policy issues. But the deeper problem, beyond Trump’s distinct lack of fitness, is that Republican ideology opposes any actual steps that would be needed to make the resources available to cover people with expensive conditions: They hate regulating the insurance market to force cross-subsidies from the healthy to the sick, and they also hate new taxes and spending. There’s a reason they never came up with a real plan even before Trump, or managed to produce one after Trump gave Paul Ryan carte blanche.
With a potentially disastrous debate on this issue bearing down, it finally became necessary for the administration to stop promising the plan would come and produce … something.
And so they have. In a media call, the administration announced a two-prong plan, of sorts. Prong one declares, “It is the policy of the United States” to protect people who have preexisting conditions. Prong two is to promise to work with Congress to accomplish that goal. That is literally it.
Needless to say, if it was possible to reform the individual insurance market by having the president issue a line declaring it so, well, health-care reform would have gone a lot easier for every Democratic president since Franklin Roosevelt. And if a promise to “work with Congress” meant something, one has to wonder what exactly they were doing when they spent a year fervently trying to muscle a bill through Congress. Do they think the only reason they failed is that they neglected to issue the all-important “work with Congress” executive order beforehand?
Trump was worried enough about health care that he finally had to stop promising the terrific plan would come in two weeks, and start saying it had arrived. The difference with the scene in The Grifters, of course, is that reporters can see there’s nothing behind the door. But this is Trump, who is literally a professional grifter by trade. He’s just going to insist the empty room is actually filled with sophisticated computers, and the fake news is lying. It will be up to Joe Biden to expose him.