Democratic governance rarely rises to the cinematic denouement of the fight over the American Health Care Act that ended yesterday morning in the US Senate. Vilified after backing a “motion to proceed” with further debate of the controversial measure, at the last possible moment Sen John McCain scuttled his party’s seven-year-long effort to overturn the former president’s signature legislative accomplishment. McCain’s dramatic appearance in the chamber, despite a recent brain cancer diagnosis, was further heightened by the fact that his coup de grace – a simple thumbs-down gesture – was delivered a few feet away from Republican Senate Majority Leader Mitch McConnell, who looked on sternly with folded arms.
Behind the scenes McCain also reportedly rebuffed eleventh-hour appeals from both the President and Vice-president.
McCain’s subsequent statement says a lot about Washington’s hyperpartisanship since the Obama years. Making clear his distaste for Obamacare, and his belief that it should be replaced by a system that “increases competition [and] lowers costs,” McCain notes that in Arizona, his home state, “premiums are skyrocketing and health care providers are fleeing the marketplace.” Nevertheless, while the ‘skinny repeal’ that the GOP was trying to force through the Senate would have ended some of Obamacare’s “most burdensome regulations”, McCain notes that it “offered no replacement to actually reform our health care system and deliver affordable, quality health care.” Noting that the original measure was “rammed through Congress by Democrats on a strict-party line basis without a single Republican vote,” McCain instead urged his colleagues to “avoid the mistakes of the past that has [sic] led to Obamacare’s collapse.”
In the United States, healthcare reform requires a painstaking attention to detail and a judicious balancing of competing interests. President Trump seems incapable, or unwilling, to deliver on either front. His exasperation with the process – “Nobody knew health care could be so complicated” – has already broadcast his profound ignorance of debates in the Clinton and Obama administrations. Even more revealingly, his response to yesterday’s Senate vote was a petulant tweet that the GOP should “let Obamacare implode” – as though this prospect were a mere abstraction and not something that would affect twenty-million Americans and in many cases endanger, or even prematurely end, their lives. Other tweets proposed that “If Republicans are going to pass great future legislation in the Senate, they must immediately go to a 51 vote majority, not senseless 60” – as though the use of a similar and widely-criticized tactic to get Obamacare passed could be harmlessly repurposed.
The Senate healthcare drama – and its ongoing repercussions in US politics – are a stark contrast to the inclusivity that the 44th president aspired to, albeit in vain, throughout his two terms. During his final State of the Union address, Pres Obama presciently observed that democracy required “basic bonds of trust between its citizens” and, with painful hindsight, added that: “It doesn’t work if we think the people who disagree with us are all motivated by malice, or that our political opponents are unpatriotic. Democracy grinds to a halt without a willingness to compromise; or when even basic facts are contested, and we listen only to those who agree with us.” The omnishambles of the Trump administration has provided irrefutable proof of these assertions. When a democracy’s basic assumptions are undermined to the point of meaninglessness, the resulting mistrust not only impedes “great” legislation and the “winning” that Pres Trump promised his base, but the day-to-day functioning of the system itself.