Boehner says you can’t repeal and replace quickly—and he’s tried

March 9, 2017 at 8:00 AM Leave a comment

Winning was easy.  Governing’s harder.—Cabinet battle #1, Hamilton the musical

boehner-by-dsc_0595

In one of the more surreal moments lately (and there have been a few), former Speaker of the House John Boehner said at HIMSS 2017 that Republicans would not be able to repeal and replace the Affordable Care Act.  Here’s the quote:

boehner-quote

The irony of this is that it was probably politically impossible for him to say that while he was Speaker.  There is a scene from the Aaron Sorkin drama The West Wing in which a political consultant chides one of the characters for resolving what would have been a juicy campaign issue.  “You don’t want the money, you want the issue.”  The ACA was too juicy an issue to resolve in the simple manner Speaker Boehner describes, and that many of my Republican friends have been advocating for, for years.  Resolving it would have removed a campaign issue that was a slam-dunk-automatic-applause-getter winner for Republicans in this last election cycle.  You don’t want to resolve the issue; you want angry voters mobilized against the other guy.

But like the proverbial dog that caught the car it was chasing, it isn’t clear what Republicans can actually do quickly to unravel the complexities of the ACA.  I think the ACA probably deserves a fair amount of criticism for its complexity, but then again, the issue of sustainable health coverage in the era of billion dollar medical miracles is, well, pretty complex.   You want to make things affordable, but you also want to give people comprehensive coverage so they don’t worry they’ll lose everything they have in a single medical event.  If you ask the American public which one they want, they’ll say, “Both, of course!”  Me too.  But that involves getting healthy people to buy insurance, while guaranteeing everyone can buy it, while subsidizing a fairly large segment of the population that can’t afford to be as sick as they are.  Each of these aims works against the other two.

It strikes me that the hard reality of complex subjects in the nanosecond attention span world in which we live is this: it’s a lot easier in fifteen seconds to make something complex sound bad than it is to make it sound good.  This is supported by a lot of neuroscience and behavioral science work in the last two decades that show that our first response to anything novel is to evaluate it as a threat, and then only when we’re sure it’s not, can we engage in rational thought.   So guess which kind of problem governments typically are asked to solve?

So I don’t blame John Boehner for not saying what he said at HIMSS back when he was Speaker.  After all, he didn’t make the rules, he just played the game as well as he could.  The bigger question is, how do we reduce the reward for making complexity bad, and increase the reward for thoughtful problem-solving?

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Is A Better Way Actually Better? It’s here, it’s here, the House Republican ACA repeal and replace bill!

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