While the keyhole of history has had insufficient time to bring the failed launch of the American Health Care Act (AHCA) into focus, it’s not too soon to begin learning some of the lessons it can teach us. Legislative efforts have a lifespan but our health care system does not. So whether we are still rejoicing or recriminating, let’s take a look at some timeless principles we can apply to the ongoing effort to improve health care in the United States.
1. Nothing Is Inevitable
Remember how we were all told Affordable Care Act (ACA) repeal would be on the President’s desk on Inauguration Day? After all, Republicans had already voted for it several dozen times, most recently in January 2016 in an attempt to override President Obama’s veto. Now that they had control of the White House, what could stop them?
As I pointed out in my Health Affairs Blog post last December predicting ACA repeal would fail, however, there’s a difference between making a political statement and enacting real policy. The latter is invariably complex and time-consuming, creating vulnerabilities and pitfalls both known and unknown at the outset. While a cornerstone of tried and true policymaking is to leverage the “strategy of inevitability”—more than seven years ago, the ACA campaign itself vigorously deployed just such a strategy—the underlying premise of that strategy is always inherently false.
– Health Affairs