President Donald Trump pulled ‘Trumpcare’, or the American Healthcare Act (AHCA), late last week, before it could even be voted on. Why? Because to do otherwise would have shown the overwhelming lack of support the President’s health care reform bill had. Losing this vote would have been a massive blow to the self-professed deal-maker – so canning it once he realised he didn’t have the numbers seemed like the logical move.
But, let’s be honest, pulling his reform bill has pretty much the same effect.
The bill is largely a smokescreen for House Speaker Paul Ryan’s hard-on for reforming Medicaid, a program that 70 million poor Americans depend on for their healthcare. The rest was hastily put together, and thrown out to the vote at the tender age of two-and-a-half weeks. 123 pages in total (seven of which were dedicated to special rules and conditions ensuring lottery winners weren’t ever given access to free healthcare). It also contained the foundation for billions in tax cuts for the ultra-rich, and handed back power to the insurance companies, who already make billions in profit each year.
Now, to contrast, ‘Obamacare’ took more than a year to pass through the same stage. It was a widely-consulted, considered document numbering around 1,000 pages – and growing to more than 30,000 pages as it was refined.
But for many Americans, the complexities of the health care debate dominating Washington at the moment are not front of mind.
I’d bet dollars (not Trumpian-level dollars) that the people I interviewed in Wise, Virginia don’t care about the Trumpcare defeat. It’s an area that voted 79 per cent in favour of the new president – and an area that doesn’t care much for the ins-and-outs of politics in Washington – where a lot of people live in trailers, RVs or caravans.
Ironically, they were also the people that stood to lose the most from this bill. ‘Trumpcare’ would have reduced the limited access they have to Medicaid (the closest thing the US has to socialised state-funded health care) – and made private insurance more expensive if they decided to take it up. Amazingly, the President himself admitted as much in an interview last week – whilst still trying to push the bill through Congress.
Inevitably, the commentary this weekend – the public autopsy of the AHCA – has alluded to President Trump’s deal-making skills.
‘Deal-maker’ is a trait that the President holds dear, and uses to define himself above all others. But with the repeated blocks of his Executive Orders and the failure of Trumpcare – the chasm between the dealings of politics and business must be coming into sharp focus. If they’re not, they probably should be. The United States has a president that’s less interested in getting lawmakers on his side than he is in crowd-sizes or angry tweets, and that is going to make governance difficult in the next couple of years. Getting a Republican Congress on board to repeal a bill that its members have been hating on for the last seven years should have been easy. But in the end, Trumpcare pleased ‘none of the people’, ‘all of the time’.
Reporter Dean Cornish (L) and producer Ronan Sharkey filming Virginia. Source: SBS Dateline
I wondered this weekend if the protestors I met in New Orleans, Louisiana would be happy about the failure of Trumpcare. For this , we met plenty of people who wanted to keep Obamacare intact. These people liked having access to medicine, and doctor’s visits – and although their insurance policies were expensive, they preferred them to personal exposure to thousands of dollars of medical bills – which are a part of life for the uninsured.
But the fact is, the failure of Trumpcare isn’t a victory for Obamacare – which itself is unsustainable without tweaks, checks and balances. President Trump has vowed to now let Obamacare ‘die out’. When this happens, people will die out with it.
It’s interesting and frightening to see what life looks like without a backstop.
In the United States, it can be very easy to slip outside the system and near-impossible to get back into it. Whilst driving through South-West Virginia, I mused that while I’ve definitely been to less wealthy places in the world – I’ve not seen many places more disadvantaged. Being American, for some, carries a sense of entitlement, and a crippling day-to-day financial cost for basic existence. But the industry and pay checks in places like Wise fall a long way short of sustaining it. The winters are cold, the houses are damp, and the rusting coal mines dotting the landscape taunt inhabitants with allusions to former greatness.
The debate here is all about affordable insurance policies to counteract expensive healthcare. A visit to the emergency room can easily run to US$7,000. Drugs that are simply manufactured, but mean life-or-death for the recipient can run to tens of thousands of dollars a month, every month. Treating a child with cancer can run into the millions. Despite all this, very few people seem to be asking, or protesting, about why healthcare is so darn expensive here in the first place.
Back in Wise, Virginia, people are keeping their faith in the new president – for now. Really, the last time they voted, protested or engaged politically, they did so for Trump. For ‘change’. And they still believe this Washington outsider, maverick businessman, deal-maker can bring it to them.
I can’t help but feel the president wouldn’t sit a moment in their trailers, let alone walk a mile in their shoes.
