By John Daniel Davidson
Monday, April 03, 2017
What should President Trump do about the defeat of
RyanCare? After House Speaker Paul Ryan’s health-care bill stalled in the
House, Trump suggested he might just leave Obamacare in place and let it
explode
No one else seems to want that, though. Some
conservatives are trying to revive the effort to repeal and replace, in May or
maybe even sooner. Many on the Left have seized on the failure of Ryan’s American
Health Care Act as a sign that it’s time for Democrats to work with Trump on a
single-payer health care system that “takes care of everybody,” as Trump
himself promised during his presidential campaign.
It’s not just the Left. Frank Buckley, the conservative
law professor and author who helped organize “Scholars and Writers for Trump,”
agrees: it’s time for Trump to embrace single-payer. In a recent column for the
New York Post, Buckley doesn’t try to
make a policy argument for a Canada-style national health-care system, he makes
a political argument for it.
Buckley believes RyanCare’s defeat could be a triumph for
the Trump agenda, “if used wisely as a means of reinventing the Republican
Party as a party of working Americans of all races and ethnicities. Split the
Republican Party, if need be.”
Trump’s Coalition
Was Anti-Obamacare Republicans
He claims “the people who elected Trump” would support
such a plan, then offers a caricature of those people that could have come
straight from the New York Times
editorial board: “They weren’t right-wing ideologues. They were people who had
lost or who feared they’d lose their jobs. Many were but a few steps away from
the diseases of despair, social isolation, drug and alcohol poisonings and
suicide that Anne Case and her husband, Nobel laureate Sir Angus Deaton, tell
us have lowered the life expectancy of white Americans.”
It will no doubt come as a surprise to the tens of
millions of middle-class Republican voters who supported Trump that “many” of
them “were but a few steps away” from “diseases of despair” like suicide and
heroin addiction.
Trump did attract crucial support in parts of the Midwest
and Appalachia where the manufacturing economy has been hollowed out and
communities have been ravaged by drug abuse and suicide. But the relatively
small numbers of rural and suburban voters that helped swing certain counties
in Pennsylvania and Wisconsin for Trump hardly make up a powerful political
constituency, especially when it comes to something as big and important as
health care.
The fact is, Trump’s coalition was made up largely of
regular old Republicans, the same voters who have been sending lawmakers to
Washington for seven years on promises to repeal and replace Obamacare. The
defeat of RyanCare exposed huge problems with GOP House leadership’s grasp of
the political moment and what’s expected of them, but it didn’t redraw the
national political map.
Upward Mobility
Isn’t the Problem
Buckley’s argument for single-payer doesn’t amount to
much. But his logic illuminates a divide in conservative circles between those
who attribute Trump’s win to economic factors like income inequality and
economic mobility, and those who attribute it to cultural factors like political
correctness and the wholesale rejection of our political elites.
Buckley falls into the first camp. Last year in an essay
for The American Conservative, based
partly on his recent book, “The Way Back,” Buckley says that to win elections
again, “conservatives should begin by admitting that income mobility is the
defining political issue of our time, that we lost the 2012 election because we
ignored it, that anger at the class society we have become explains the rise of
Donald Trump, and that the way back lies in the pursuit of socialist ends
through capitalist means.”
But is income mobility really the defining political
issue of our time? In his 2014 State of the Union Address, President Obama made
similar claims. Corporations were doing great, he said, “But average wages have
barely budged. Inequality has deepened. Upward mobility has stalled.”
The problem is that such claims don’t bear close
scrutiny. Much of Buckley’s argument, both in his essay and book, relies on a
single study that has been soundly debunked by a number of economists like
Scott Winship and Donald Schneider.
The so-called “Great Gatsby Curve,” which posits that the
United States is one of the most economically immobile countries in the
developed world, is deeply flawed. Winship wrote that it “is of practically no
use” in trying to determine the future of economic mobility in America. The
truth is, when measured properly, mobility in America is about the same as it
is in Sweden and Canada.
Why is this important in the context of a health care
debate? Because if you believe that Trump was elected to ameliorate income
inequality and boost economic mobility, if you think his supporters want him to
enact policies to those ends and build a coalition in Congress to realize them,
then there’ll be no fine distinctions between “socialist ends through
capitalist means.” In that case, we might as well have signed up for Obama’s
third term.
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