Robert F. Jakubowicz: 'Pants on fire' for Trump on ACA replacement

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By Robert F. Jakubowicz

PITTSFIELD
"He who permits himself to tell a lie once. finds it much easier to do it a second and third time, till at length it becomes habitual; he tells lies without attending to it, and truths without the world's believing him " - Thomas Jefferson

When Jefferson made this observation of human nature, he surely must have had someone like President- elect Donald Trump in mind.

PolitiFact had documented Trump's many presidential campaign statements, well beyond Jefferson's third time, that were "mostly false, false or pants on fire " Trump has done this habitually to the point that it is now being taken for granted.

One example was a recent discussion on MSNBC about replacing the Affordable Care Act (Obamacare.) Steven Brill, the author of the book "America's Bitter Pill: Money, Politics, Back-Room Deals and the Fight to Fix Our Broken Healthcare System," predicted in this discussion that there would be no replacement of the ACA until at least the next congressional election and very likely beyond that time. This prompted the host, Lawrence O'Donnell, to remark that Trump would then just lie around his inability to deliver on one of his major promises to repeal and replace that law. Brill agreed without any hesitation.

Institutional foes

Brill's reasoning for a long delay in replacing Obamacare was based on an underreported aspect of replacing this law. He thinks there would be no Obamacare without the support of such industries as the drug companies, non-profit hospitals, and medical device makers. They are currently "happy" making more money under that law and Brill said they would present a formidable opposition to a replacement law that will affect their financial interests under the existing law. In the past, every turn to cut costs, according to Brill, were stopped by these industries and their lobbyists.

During the presidential campaign and after his election, many Trump supporters took for granted that he would not actually repeal and replace Obamacare, despite his vow to make it one of his first presidential priorities. Trump's mention of it drew large cheers from his audiences. He used it often to whip them up. Just the mention of it drew a frenzied response from the crowd like the response of Pavlov's dog to a bell.

A number of Trump supporters in television interviews, however, said that they either did not take him seriously or care what he was saying about Obamacare. They said they voted for him to send a message of change in Washington.

To try to figure out whether Trump was "mostly false, false or pants on fire" on this issue of repealing and replacing Obamacare, one has to look beyond the many times, he merely mentioned it. This law is complex and lengthy. It interconnects the many pieces of the health care system, such as visits to doctors, medical treatments, regulation of health care insurance coverage, costs of health care insurance, government subsidies, Medicaid, insurance exchanges, mandatory insurance coverage, and the like.

There are also many regulations promulgated under this law and new regulations are still being added. It is a law that simply cannot be repealed without doing anything to cover all the parts of the health care system. Otherwise there will be major chaos for the insurance industry, hospitals, medical care professionals, people in need of medical treatment, etc.

Yet despite all the hard legislative work that is involved in recreating an entirely new health care system to replace Obamacare, all Trump has been doing is talking about it. One would have reasonably expected that he would have a plan or at least an outline of plan in place to deal with this issue as he takes office, He had plenty of time during the campaign to have done this.

No plan anywhere

Trump has neither a draft of a replacement health care law nor an outline of one, unless he is keeping it a secret, which I doubt. So far, the only move in that direction by him is to wait on the GOP congressional majority, especially Speaker of the House Paul Ryan, who has set himself up as an expert on health care law replacement., to prepare one for him. That is a dubious move by Trump because Ryan and his GOP House members have voted in the past some 50 times to repeal Obamacare but not once have they proposed or passed a replacement measure for it. And at this point they still don't have one.

Ryan recently said: "We're just beginning," adding that there are some good ideas in his body and he is waiting for the confirmation of Trump's pick for secretary of Health and Human Services, Rep. Tom Price. Price is an advocate for a free market solution for health care. He most likely would just want go back to pre-Obamacare days. The likely outcome will be a law to repeal Obamacare to go into effect at some arbitrary future date without any replacement measure.     

Based on the performance by Trump outlined above, I rate his repeal and replace with something much better and less costly vow as partly false because of the likely delayed repeal, but a "pants on fire" lie about a great replacement.

Robert `Frank" Jakubowicz is a regular Eagle contributor.

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