November 13th, 2016
by Jeffrey Lewis
Given the historic election of Donald Trump, it’s easy to miss the true message sent by the electorate. With Republicans winning control of the presidency and Congress, voters signaled a desire for leaders to work together to solve the nation’s most difficult domestic policy problems. That requires Republican leadership in Congress that is serious, focused on action not rhetoric, and understands this historical moment. The first step: the re-election of Paul Ryan as Speaker.
Unlike in 2008, when voters handed relatively unified Democrats control of the Presidency, Senate, and House, President-elect Trump will head a government controlled by various factions of the Republican party. If Republicans have any ambition to make any progress on domestic policy, Mr. Trump and other Republicans need the support of Democrats in Congress to create bipartisan legislative initiatives.
Unlike ObamaCare, where the Democrats passed it without one Republican vote, the future of domestic and foreign policy cannot and should not be purely Republican. The cross fertilization of ideas, strategies and communication are the hallmarks that this nation was built on. A Trump White House and a Republican Congress stand at an important crossroads in history; they must embrace the bipartisanship practiced by former Republican Senators Bob Dole, John Heinz, Bob Packwood, and others who reached across the aisle to build solutions to issues concerning domestic and foreign policy.
Speaker Paul Ryan is a student of history who understands that the past is our teacher. Most people view Paul Ryan as a principled, conservative Republican who is deeply committed to advancing equitable solutions to America’s challenges. On many issues –budget, trade, immigration, poverty and entitlements — he’s demonstrated a willingness to reach across the aisle and put bipartisan policy ahead of partisan politics. He looks at America as one nation.
At worst, a re-elected Speaker Ryan would check the power of a newly elected president by embodying the system of checks and balances our founders enshrined in the Constitution. At best, Mr. Ryan and Mr. Trump would find common ground and forge bipartisan solutions to address our unsustainable entitlement programs, our broken immigration system, and other tough national problems.
Particularly in the area of healthcare, the road ahead is full of gaping holes. Unlike ObamaCare, which was passed without a single Republican vote, solutions to our numerous healthcare challenges demand bipartisan resolutions. Medicare and Medicaid are operating at an unsustainable financial pace; the nation is desperate for a long term care policy that recognizes the needs of middle class retirees and the children of aging parents (mostly women) who often leave work to be caregivers, which results in a severe economic loss to themselves and their families; adolescent mental health has become a national public health crisis; and we still have millions of children going to school hungry.
The humanity of healthcare under the leadership of Speaker Ryan would reflect American values and the needs of American families. Ryan understands how to take the politics out of entitlements to create real solutions.
Equally important is how best to fulfill President-elect Trump’s and other Republicans promise of replacing ObamaCare. The tenets of TrumpCare should be founded on the principle that middle class families are protected, and that providers are paid at market-rate for services not the Medi-Cal rate because it simply drives doctors away from treating patients.
Republicans also have a unique opportunity to address the long term care needs of millions of aging and disabled Americans. Part of this discussion should include how to reward, not penalize, children of aging parents who leave the workforce to care for mom, dad or a disabled child.
Paul Ryan has repeatedly shown a willingness to engage in substantive discussions about the future of America’s healthcare system. If President-elect Trump wants to get past the reflexive “repeal and replace” attitude prevalent within the GOP, he must remain open to Republican reform ideas and strategies to tackle everything from primary care to long term care.
New presidents often talk of their first 100-day agenda. And, many fail. A newly re-elected Speaker Ryan could help a Trump White House build a real, achievable agenda. One that embraces the candidate’s promises, America’s hope and a path forward in tackling some tough economic issues. Leadership, real leadership, will be demonstrated by discussions on tax and entitlement reform.
If the past is any guide, such an opportunity won’t remain open long. But it starts with Speaker Ryan sitting behind President Trump at his first State of the Union speech as he delivers a bipartisan message that, for the first time in decades, brings both parties to their feet.
— Jeffrey Lewis is President and CEO of Legacy Health Endowment, a Turlock -based philanthropy dedicated to creating innovative healthcare solutions for Stanislaus and Merced counties.