Next step: Fix health care

The efforts by congressional Republicans to repeal the Affordable Care Act seem to be grinding down to only occasional and ad hoc efforts, and that is good news. But one thing can be said about the GOP—it offered alternatives, as dubious as they were.

As it happens, the Democrats have not done the same.

No one, least of all Democrats, ever considered the ACA to be a final product. It was the result of the Senate’s sanity-challenged procedures in which majorities do not rule and a single senator can halt all action. It was a patchwork of ideas and sections designed to satisfy individual senators. Nevada’s Harry Reid, then the Democratic leader, said the program could one day be made better.

When Republicans won a majority of both houses of Congress last year, they went into the new session without a new version of health care ready to go. Being unready for that battle lost the initiative for Republicans, and they never got it back.

The nation is about nine weeks away from the next election year, one in which Democrats have an excellent chance of regaining lost ground, thanks to their best campaigner—Donald Trump. For decades, the Democrats’ vacuous corporate-driven stances have meant that they win mainly when Republicans lose, which does little to create mandates for subsequent congressional action.

It would be nice if, this time, the Democrats shed toadying to corporate money and tell us what they are going to do to change the ACA. They’ve apparently saved the program, but the program was never supposed to remain as it is, and its troubled state now requires some preparations for the 2018 campaign. A status quo approach to health care in indefensible, yet we have no idea what the Democrats are going to do if they win back a majority.

Ron Fournier wrote a National Journal article, “Why I’m getting tired of defending Obamacare.” That was three years ago and came from a supporter of the program.

The ACA has a lot of achievements to its credit. Health coverage has risen. Bankruptcies caused by health care bills have fallen. Lifetime limits on coverage are gone. And both the enactment of the ACA and the Democrats’ battle this year against repeal-and-sort-of-replace have gone a long way toward establishing the principle that national health care is needed.

But health care is still far from affordable. And toadying to the insurance market drives many voters crazy. The program badly needs simplification.

Sen. Bernie Sanders has introduced Medicare-for-all legislation, and a substantial number of Senate Democrats have joined him, while House Democratic leader Nancy Pelosi is hanging back.

Here in Nevada, we don’t know where candidates’ heads are at. Democratic candidates for the House and apparent Democratic U.S. Senate candidate Jacky Rosen all need to speak up and tell us how they would fix the ACA. A national consensus is needed. This is one time when just being against the Republicans is not enough.