THE HEALTH-CARE VOTE – AT 9:58 A.M. ET:   The House will, unless there's a change, vote on the GOP health-care bill later today.  The outcome is in doubt, with a number of Republicans expressing opposition.

The opposition is understandable.  Republicans have had eight years to come up with a coherent replacement for the failing Obamacare program, and didn't do so.  What is proposed today is a patchwork job, improved through President Trump's skillful intervention, but still not the stellar plan that we had a right to expect. 

Gerald Seib, of The Wall Street Journal, presents a thoughtful analysis of the dilemma:  

Former President Barack Obama tried the big fix in health care and he came away with the scars to show for it. Now, House Speaker Paul Ryan and President Donald Trump are trying for the big health-care fix, and they are coming away with the scars to show for it.

Maybe there is a lesson in there.

It is this: Health care is such a giant national issue that it isn’t easily or effectively resolved with broad plans that have only narrow partisan support. When that is attempted, even small factions within a single party have the power to disrupt things. That is precisely what has happened to Messrs. Ryan and Trump as their plan hit a roadblock built by members of their own party.

The president and the speaker may well bring their bill back from the brink of disaster in the House in the coming hours or days, by making fixes designed to please just enough conservative Republicans without offending too many moderate Republicans.

But that will only ensure that the legislation is headed for a similar minefield in the Senate, and then, if it passes the Senate, an even more perilous one when lawmakers try to reconcile whatever the House passes with whatever different plan finds its way through the Senate.

Then, even if a big health plan can be muscled through Congress on a strictly party-line vote, the lack of any bipartisan buy-in means it lacks the broad support to be sustainable. Mr. Obama and the Democrats are learning that as their plan is being thrown overboard by the GOP at the first opportunity.

Obviously, this isn’t optimal for either party, or for the nation’s giant health-care economy.

Perhaps the only way to do a comprehensive rewiring of the nation’s health system that has sustainable support is to do it with a broad bipartisan coalition. Yet clearly such a bipartisan coalition doesn’t exist right now. Perhaps one can emerge only if the health system truly appears to be approaching a disaster, much as the two parties could only come together to fix Social Security in the 1980s when the system appeared to be headed toward disaster.

COMMENT:  When Obamacare was passed, it was noted that it was the only major social legislation in American history to be adopted without some bipartisan support.  Not a single Republican voted for it, and Democrats made it plain they didn't care.

Seib has a point.  Maybe legislation of this kind simply requires a broad coalition, even though neither side will get all that it wants.  For if the GOP bill passes the House today, it will surely be completely rewritten in the Senate, setting up a clash between House and Senate Republicans.  Not good.

News stories today suggest that President Trump now believes it would have been wiser to take up tax reform as his first legislative issue, and I think that's correct. 

March 24,  2017