President Trump and House Republicans, in their rush to resuscitate a bill rolling back the Affordable Care Act, are increasingly isolating themselves from outside input and rejecting entreaties to work collaboratively, according to multiple healthcare officials who have tried to engage GOP leaders. The White House and its House GOP allies are hoping to reschedule a vote on their overhaul plan in the coming days, following last month’s embarrassing retreat when the bill was pulled shortly before a vote. But they continue to refuse to reach out to Democrats. Even Senate Republicans have been largely sidelined, though their support will be crucial to putting a measure on Trump’s desk. And senior House Republicans and White House officials have almost completely shut out doctors, hospitals, patient advocates and others who work in the healthcare system, industry officials say, despite pleas from many healthcare leaders to seek an alternative path that doesn’t threaten protections for tens of millions of Americans.
Politicians are naturally inclined to craft these reforms behind closed doors given the fact that medical care in the United States — and particularly who pays for it — is a textbook example of a wicked problem. Soliciting input from stakeholder groups is likely to lead back to square one: everyone agrees there’s a problem, but no one can agree on how to solve it and there’s little common ground. So policymakers say to themselves, “OK, we’ll decide for them.”
Given the nature of the challenge when it comes to health care reform, Hillary Clinton went behind closed doors in 1993, convening an assortment of 100 policy wonks and experts as the Task Force on National Health Care Reform to forge the Clinton administration’s ill fated Health Security Act. However meritorious the legislation was, it was dead on arrival in Congress due to the perception it was drafted in secret without sufficient stakeholder input and strong opposition from health plans and small business.
Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email