Repeal And Replace Is Not Just About Health Care

Republicans should revise Cato’s admonition Carthago delenda est (”Carthage must be destroyed”) to Obama delenda est and make it their party’s motto.

My family has been self-insured for the past 18 years. Our annual premiums went down by more than $18,000 in the first year of the Affordable Care Act (ACA), and we got better insurance. In my experience, its most virulent opponents know nothing about it.

I’ve also found that some who get their insurance through the ACA don’t realize that it IS Obamacare. Yesterday I saw a post on the Crooks and Liars website listing some online comments confirming this:

“I’m not on Obamacare. My health insurance is through the ACA (Affordable Care Act), which was what they had to come up with after Obamacare crashed and burned as bad [sic] as it did. So I’m gonna be fine.”

(As an aside, I think the president’s decision to embrace the term “Obamacare”—I do not use this term at all—was a great strategic blunder. It unnecessarily personalized and politicized a seminal public policy issue. Consider, as David McCullough describes in his biography of Harry Truman, that Truman expressly wanted his idea to be called the Marshall Plan. He knew that attaching his name to it could be politically toxic and therefore convinced George Marshall, whose reputation among Republicans and Democrats alike was impeccable, to allow his name to be used for the policy. Or think about how much more difficult, in the early days, it would have been to institutionalize Social Security had it been called Roosevelt Social Insurance.)

Secondly, I suspect, especially after Trump’s “press conference” yesterday when he said repeal and replace of the ACA would take place simultaneously, that his endgame strategy is one of rebranding, not reforming. Just as he licenses his name to make most of his money, he will, I strongly believe, do all he can to do the same with public policy. It has been speculated that his view that conflict of interest laws will not apply to him as president has the potential of creating a new age of kleptocracy. The most valuable asset he can bequeath his children is his name with the added value presidential cachet. In order to increase its value, Trump will unconsciously (because I’m confident he has no idea who Cato or what Carthage were) follow Cato’s dictum with respect to the Obama legacy. Much like the Stalin-esque practice of scrubbing history of facts, his rewriting of history will focus on eliminating as many traces of anything that goes counter to his desired narrative to inform the future.

I was a high school government teacher in the 1980s, when the Cold War was our guiding foreign policy issue and our greatest fear was nuclear war with the Soviet Union. I spent time teaching about Stalin, using Orwell’s Animal Farm as a text to teach my students that the scrubbing of history and desecration of language was just as great a threat as the Soviet bloc military threats posed. For the final exam, I used the opening page of Milan Kundera’s novel The Book of Laughter and Forgetting to ask the students to write an essay comparing the passage with what we had learned over the past semester. I share it here because I think it speaks to a central tenet of Trumpism, which, sadly has many echoes in the dark ages of Stalin:

“In February 1948, Communist leader Klement Gottwald stepped out on the balcony of a Baroque palace in Prague to address the hundreds and thousands of his fellow citizens packed into Old Town Square. It was a crucial moment in Czech history—a fateful moment of the kind that occurs once or twice in a millennium.

“Gottwald was flanked by his comrades, with Clementis standing next to him. There were snow flurries, it was cold, and Gottwald was bareheaded. The solicitous Clemintis took off his own fur cap and set it on Gottwald’s head.

“The Party propaganda section put out hundreds of thousands of copies of a photograph of that balcony with Gottwald, a fur cap on his head and comrades at his side, speaking to the nation. On that balcony the history of Communist Czechoslovakia was born. Every child knew the photograph from posters, schoolbooks, and museums.

“Four years later, Clementis was charged with treason and hanged. The propaganda section immediately airbrushed him out of history and, obviously, out of all the photographs as well. Ever since, Gottwald has stood on that balcony alone. Where Clementis once stood, there is only a bare palace wall. All that remains of Clementis is the cap on Gottwald’s head.”

It is chilling to think that a relic of history in 1948 is as relevant today, in 2017, as it was then. The fate of the Affordable Care Act is about more than health care.