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Zaleski: Obama still sets the agenda

Here's a fact that must stick in the craw of Republicans in Congress: The only reason they are in the thick of a no-win health care debate is President Obama. He accomplished what administrations since Harry Truman were unable to do. His Affordab...

Jack Zaleski, The Forum Michael Vosburg / Forum Photo Editor
Jack Zaleski, The Forum Michael Vosburg / Forum Photo Editor

Here's a fact that must stick in the craw of Republicans in Congress: The only reason they are in the thick of a no-win health care debate is President Obama. He accomplished what administrations since Harry Truman were unable to do. His Affordable Healthcare Act forced the debate on resistant Republicans.

Last week's Senate carnival, featuring a profoundly nasty and stingy answer to Obamacare, was exposed as little more than a poorly drawn, face-saving stunt that does not "repeal and replace" Obamacare, as Republicans have been promising to do for eight years. Rather, it attempts to stamp a GOP imprimatur on a phony bill that would not have been on the GOP slate had Obama not made health care a priority. In that context, Republicans have been forced to confront the nation's health-care dilemma by a former two-term Democratic president who is far more popular and respected than the current occupant of the White House (or exclusive golf club or ultra-fancy hotel or wherever he spends most of his time).

Obama is still setting the agenda. How's that for satisfying irony?

And what do Republicans want to do? First, both House and Senate versions of the bill would toss some 20 million low- and middle-income Americans out of the health-care boat, according to the nonpartisan Congressional Budget Office. While routinely denigrating CBO's work when it doesn't conform to their flimsy narrative, Republican Senate leaders and their stranger-than-fiction leader in the Oval Office insist they are not cutting Medicaid, but are merely "slowing the growth of Medicaid." It's an absurd sham, easily exposed. As population grows, support programs must grow. More resources are required to help more people secure affordable health insurance via Medicaid expansion. If the growth of Medicaid is "slowed," it's a guarantee millions will be without a health insurance option in the future, as the CBO analysis clearly shows.

The debate is as much about political ideology as it is about health care. Democrats want more government support so families can secure affordable care and/or insurance. Republicans believe the system should be pushed to the free market, which would stimulate competition and bring down costs. Democrats have the better argument. Republicans are dismissing reality.

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At one-sixth of the economy, health care is, has been, and will be a major government responsibility. Think Medicare, Medicaid, the Veterans Administration (pure socialized medicine), the National Institutes of Health, the FDA and more. None of these government functions is going into some mythical free market.

The mean-spirited (the president's description) House and Senate health-care bills will not stand. Some version of reform will emerge because legislation as big and complex as Obamacare will need tweaks as its many provisions are implemented. But "repeal and replace" will be more Obamacare than Republicans will ever admit. If they eventually pass something, they will preen and crow about having kept their campaign promises. But in the end, President Obama will be able to flash that trademark smile. He'll have won the debate-again.

Zaleski retired in February after nearly 30 years as The Forum’s editorial page editor. He will continue to write a Sunday column. Contact him at jzaleski@forumcomm.com or (701) 241-5521.

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