The Democrats have once again rolled the Republicans.  They did it, as always, by controlling the terms of the discussion.

All throughout the Obama era, Republicans (quite rightly) complained about Obamacare.  They passed a seemingly unending series of repeal bills, some of which made it through the Senate and one of which actually made it to President Obama's desk...for an ultimate veto.

How did the Democrats win this time?  By constantly harping on the Republican Party: So what's your plan, Republicans?  The Republicans, true to form, backed down and bought into the Democrat/Statist narrative of the necessity for federal involvement intervention in medicine and promised a replacement plan.  Their campaign slogan changed from Repeal! to Repeal and Replace. Thus, no matter what, the least that would happen is that medical care in the United States would remain to the left of where it was in 2008, giving the Statists the win.  Prime Minister Margaret Thatcher once referred to this as the "ratchet effect."

Speaker Ryan owns a large chunk of this, along with his long serving establishment posse.  However, President Trump also has some ownership, and here is why.  Donald J. Trump has two major attributes.  On the upside, he is a doer.  He knows and has demonstrated that he can get things done...on time and under budget.  Not only was he a success in the business community, but as a political novice, he beat the well funded Clinton machine...a machine that spent almost twice what he did and employed over six times as many paid operatives.  Any way you look at it, President Trump is a guy who gets stuff done, does it in a cost-effective way, and does so with his very own form of panache.

On the downside, there is Trump's attribute: he's a doer.  When confronted with a problem, his first instinct is to jump right in and begin to solve it.  And, as I mentioned above, he is usually, or should I say unusually, successful.  However, as president of our constitutional republic, this might not always be the best method, as recently demonstrated by his active support of the failed Ryan plan to "repeal and replace" Obamacare.  Ryan's plan, often referred to as "Obamacare Lite," failed to garner enough votes, forcing him to pull it from consideration on the floor of the House.

In his remarks after Speaker Ryan pulled the bill, President Trump spoke of the future, saying, "But I want to have a great health care bill and plan, and we will. It will happen. And it won't be in the very distant future."

Although Trump's remarks and earlier actions were those of a doer, conservatives have issue with this philosophy when applied to federal legislation in general and health care specifically.  It's a big reason why Ryan's plan failed to garner support from the House Freedom Caucus.  Conservatives don't want a (Trump's words in italics) "Big beautiful (federal) health care plan."  Such a plan would, by necessity, be run from D.C., continuing the growth of the federal government and its pervasive influence in our daily lives.  Conservatives want full repeal of Obamacare – and, after that, a series of standalone bills that remove the federal government from health care decision-making and funding, constraining it to its constitutional functions while allowing the free market to regulate innovation, quality, and costs.

In the future, Trump, the doer, might consider asking one question before jumping in to fix a problem, whether it be health care or anything else.  The first thing he should ask is, "What part of this problem, if any, is a federal (per the U.S. Constitution) issue?"  Had he done this with Obamacare, he might have found that the "federal issue" with Obamacare and the rest of health care environment in the United States is that the federal government is way too involved in the first place.  Instead of a federal plan that does things, the plan might have been simply for the federal government to stop doing some things.

Mike Ford is a sometime contributor to American Thinker who has learned over multiple decades that the first step in the Problem Solving Process is to Identify the Problem.  As Ronaldus Magnus opined, "Government is the problem."