Trump’s ego costs him opportunity on health care

When President Trump’s first major governing challenge unexpectedly crystallized last week, his failure to meet it was preordained by his personality. Because he considers himself the center of every universe, an opportunity to step toward greatness was invisible to him.

His primary failure wasn’t his inability to persuade the hard-liners in his party to go along with a cobbled-together, cynical and desperate attempt to repeal and replace the Affordable Care Act. Solomon could not have salvaged that wreck.

The opportunity arose after the decision to drop the bill championed by House Speaker Paul Ryan, R-Wis.. Trump’s reaction was tragically predictable: “Obamacare” is imploding on its own, he repeated, and Democrats will come begging him to bail them out because “now they own it,” because no Democrats, quite predictably, voted with Ryan.

A larger man with the best interests of all Americans at heart and a mature desire to change Washington’s ways would have done something quite different: directly invite Democrats to the Republican table. And a larger man would not have done it via a bullying television ad lib or juvenile tweets but with a letter articulating the goal of fixing the well-understood weaknesses of the ACA through bipartisan negotiations.

Instead, his repetition of campaign predictions of the ACA’s collapse sounded ominously like self-fulfilling prophecy, given that he and Health and Human Services Secretary Tom Price now hold the administrative levers to ensure it happens.

So Trump did nothing to end decades of partisan deadlock over how to deal with ever-rising health care costs that trigger more personal bankruptcies than any other single factor.

After eight years of loudly denigrating “Obamacare” but barred by visceral hatred of Barack Obama from thinking hard about how to fix it, the GOP has tumbled into a deep hole of its own making.

Because they dare not take away established, if sometimes marginal, coverage from 24 million people, the off-year 2018 election was a shadow over last week’s slow-motion train wreck. They failed to deliver on their continuous vows of repeal; the Congressional Budget Office does not confirm their dire depictions of an ACA death spiral; they were unable to devise a reasonable fix. One respected survey last week showed 57 percent disapproval of Ryan’s plan, only 17 percent approval.

Most of the hardliners in the Freedom Caucus who stopped the Ryan bill are from safe districts and feel no pressure to compromise. Most Democrats support the ACA, though many would like improvements. But the majority of Republicans outside the Freedom Caucus share a survival instinct, if not an ideological one to resolve health care. Working together, those two groups could relegate the Freedom Caucus to loud minority status.

Imagine if Trump could outgrow his immature instincts and constructively convene such a group, refrain from dictating to it and forgo tweeting his way around it. That would open up far more possibilities than fixing health care:

▪  Other knotty problems would have a format for resolution.

▪  New bonds could grow across partisan lines.

▪  We could begin to approach a much-needed partisan realignment, perhaps even creating impetus for a third party or more moderate majorities in each of the two major parties.

There’s no rush. Time is not of the essence; maturity is.

This story was originally published March 28, 2017 at 5:02 AM with the headline "Trump’s ego costs him opportunity on health care."