Milestone / Miles From Nowhere

Thirteen. At thirteen, a milestone, a Jewish boy is viewed to be a man.  He has a Bar Mitzvah, becomes responsible for his actions, and three days later is reprimanded by his parents for failing to do his homework.  So which is it?  Is thirteen a milestone or is it really miles from nowhere?

We have a lot of artificial milestones, deadlines to get something accomplished, a deadline to be somebody. Twenty-one seems to be the threshold to adulthood.  Fifty to being whatever we might actually accomplish professionally.  Retirement at 65.  But these are just numbers, an average, perhaps, maybe even a goal for some, but these are numbers.  These milestones are not law, not mandatory, and the first true sign of maturity is to understand that in our quest to achieve our best we must first discard artificial, imposed timelines.  While some may peak at 23, others are still honing their skills in their 70’s.  Limiting oneself to someone else’s milestones might even force someone into foolish actions.

And that brings us to Donald Trump and the rush to pass a healthcare bill next week.

Donald Trump has decided that he must repeal and replace Obamacare (The Patient Protection and Affordable Care) within his first 100 days.  This is not because he has a prescription for better, cheaper, or even easier access to healthcare for most Americans.  It is strictly because the first 100 days is a milestone.  He has no concern about leaving us miles from nowhere.

President Trump is trying to get the House Republicans to pass a bill by next Friday. And though the legislation hasn’t been written, the Congressional Budget Office hasn’t revised its scoring, and no House committee has held a single hearing, Trump thinks he can get a bill passed.  Of course, it could be passed if the details don’t matter.  Just a reminder – we are talking about close to 20% of our economy and how the doctors and hospitals get paid if you happen to get sick or injured.  The details are important.

Trump’s latest partners are two Republican House members representing two different wings of the party, House Freedom Caucus Chairman Mark Meadows and Tuesday Group co-chairman Tom MacArthur.  Together they have crafted a compromise that is more likely to anger the members of their caucuses than to garner their support.  The MacArthur Amendment (draft provided to Politico) to the American Health Care Act does not fulfill the Republican promise of repealing and replacing Obamacare, guarantee that Americans won’t lose their healthcare coverage, or even deliver more coverage for less.  They have shuffled the deck, added a couple of jokers, and then mistakenly dealt the cards face up.

The MacArthur Amendment reaffirms the value of having real standards of insurance.  The Essential Health Benefits, a list of ten benefits delineated under the PPACA, were scheduled to disappear under the original Republican plan.  This amendment brings the EHB back, but only for a moment.   Section 1 reinstates the EHB.  Section 2 allows states to seek a waiver to eliminate the EHB if they claim that this would lead to lower premiums or the possibility of more insureds.  And it isn’t just the Essential Health Benefits.  Section 1 guarantees useful insurance and Section 2 guarantees that usefulness won’t be around for long.

We are rushing towards a milestone – Trump’s first 100 days.  It is an artificial deadline. But healthcare, taxes, war and peace are not artificial.  These issues are real.  And when it comes to reality, he is miles from nowhere.

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