Only Nixon could go to China.
Only Trump can do universal healthcare.
Now, before the rafters echo with angry screams, I want to examine the idea that Trump may be able to do what progressives cannot—deliver universal health care (UHC). Whether or not Trump would do so is beyond the point. The current topsy-turvy world in which we are living needs bolder, bigger, and better ideas—not the anemic “play-it-safes” of the Democratic Party, who continue to think Pelosi will engage new voters and their concessions to big business will be overlooked, nor the unbridled nastiness of some in the Republican Party, who—quite honestly—may stand for nothing. But Trump is an outlier in almost all senses, and could use his bully pulpit to deliver on his campaign promises to “take care of everybody…Everybody’s going to be taken care of much better than they’re taken care of now.” The ugliness of that sentence aside, Trump tapped into America’s frustration with health care, and hopes that it can be better.
The Republican Healthcare Bill is likely dead.
Mitch McConnell and his cronies crafted a conspiratorial, flawed healthcare bill, and his Senators jumped ship. For true believers, the ACHA didn’t go far enough, but for many Republican Senators, the numbers spooked their constituencies. And to their credit, they listened to the people worried about cuts across the board. While anecdotal stories of Trump voters disliking Obamacare simply because Obama is in the title, reputable health care studies like that by the Kaiser Family Foundation find, while dissatisfaction with the ACA does fall along party lines, the main reason for anger is rising personal costs. The Republican bill does little to stem these costs, and much to cut off access to health care. There is a lot of great writing on our collective misunderstanding of healthcare, but overall, Americans want more access to better health care with less out of pocket expenses. Trump campaigned on repealing Obamacare, but the opportunity to do so is thinning by the day, and clearly the ACHA (or Trumpcare, which will stick to the lips of every voter who loses out on health care opportunities come 2020) doesn’t pass muster.
But universal health care can. Depending on different methods of providing UHC, costs to both the US government and citizens vary. Some ideas focus on the provision of catastrophic insurance, others as expansions of Medicaid and Medicare; some note the political and economic impossibility of eliminating insurers, while “pie-in-sky” plans see the government as the sole healthcare provider. While data are necessarily hypothetical, most reflect decreases in consumer costs with rises in government spending (achieved through taxation) that arrive at neutral numbers. But economics should not be the only consideration—do we, as a nation, see it as a moral imperative to care for our fellow Americans? Is it not part and parcel of our pursuit of life, liberty, and happiness?
Trump can expect bipartisan support.
After the election, a number of Democratic politicians and pundits made cases for looking for opportunities to work across the aisle. How could these Democrats argue against deeply progressive policy? Would this move expose partisanship that simply rests on the little (R) or (D) after a politician’s name? Moderate Republicans in districts where healthcare reform is desperately needed can be seen as making positive change, and those who rested their political fortunes on repealing Obamacare also see their needs answered. Can this coalition beat back insurance lobbyists and the pushback from the suburbs of Houston? Would Democrats fall into line behind a Trump-led push for UHC, or would their fears of Trump’s success (and potential capture of the White House again in 2020) kill this progressive ideal? This leads back to whether we are aimed at building a better America, or simply fighting for who gets to sit behind the Resolute desk. But Trump has access to a weapon neither mainstream Democrats nor insurance lobbies can wield:
Trump’s rabid, unquestioning supporters.
Since the election, I’ve come to realize that the vote was really a question of whether Democrats could engage youth (they didn’t) or if Republicans would defect from a morally-challenged provocateur (they couldn’t). Those little (R)s and (D)s determine so much more than policy, maturity, and ability. Every few days, I listen to another piece on what Trump voters want…and I’ve stopped caring. Going to deep Louisiana to track down Trump voters is functionally foolish—of course they voted for Trump, Louisiana is now dyed-in-the-wool red. More interesting are the voters in Pennsylvania or Michigan, but truly it was just about getting out the vote in the right places, and Trump did that better. Hillary won by 3 million votes, which should strike some predictive fear into Republican strategists’ hearts, but Trump appealed to enough Republicans to get them to the polling booth where it mattered.
Those voters are sticking with their appointed leader. In a Gallup poll, 85% of Republicans approve of the job Trump is doing—this in spite of ever more obvious collusion with the Russians and a spineless meeting with Putin, lackadaisical approaches to our wars, shrinking American global leadership, nepotism of the highest order, and using the office for personal gain. Trump is supported by an alternate media that twists in upon itself to explain and applaud every decision—Breitbart’s farcical characterization of Donald Trump Jr.’s email release is a masterpiece of self-deception. Trump can harness this machine against insurance lobbyists and pharmaceutical companies. His supporters will not care—as long as fake energy pills are still legal, Alex Jones will shill UHC. The Tea Party proved a focused minority can form policy, and the rank-and-file will fall in line. Trump’s tweets could be used to establish support for UHC among the base, while progressives may—while holding their noses—board the Trump Train, at least to this destination.
Can Trump take on lobbyists?
Yes, Trump talks “bigly” about changing the equation for lobbyists, but in person, he seems to seek approval and acceptance from those he views as powerful. Manipulating this submissiveness and frail ego is old hat for the ex-KGB Putin, yet Trump’s desire for little kingdoms may provide some spine. There is scant evidence that Trump has strong beliefs in anything other than himself, and this is the entry point for change. While Trump’s administration is toxic, I have to believe there are those who have entered it in hopes of actually making America great. While some lazy liberals have put their hopes in Ivanka (and what does this say about the state of “entitled liberalism”—thanks Jamie—that we believe the wealthy scion of privilege would best espouse progressive views?) this has been proven a dead end. Yet there must be some powerful progressives who could manipulate Trump better than an Amgen lobbyist. Is it morally compromising to play Iago towards the greater good? Do we need a tall, hyper-masculine, successful man with large hands to start whispering the sweet nothings of praise in Donny’s ear, weaving in the benefits of single-payer? (Unfortunately, this stereotype seems to be whom Trump falls for…sad).
I’m relying on a huge amount of assumptions, but again, big ideas aren’t built on moderation. I assume that Trump cares about his campaign promises, I assume he worries about his legacy, I assume he can bully Congress. I assume the Democrats would recognize the greater win and put aside smaller political battles. I assume moderate Republicans could be persuaded to build a better America. I assume the piles of lobbyist cash will be left on the table by politicians of all stripes.
I detest Trump and his cabal of spittlelickers, his presiding over the slow death of American power, his abhorrent tweets and pettiness. But if UHC is our China, Trump is our Nixon. And despite my assumptions, there are some truths I know: Americans can think big. Americans can do great things. Americans can extend their hands to others less fortunate. I hold these truths to be self-evident, the question is does Donald Trump?