Obamacare repeal: A brick-by-brick project, or all at once?
It is time for Republicans and conservatives to learn something from progressives.
"Incrementalism" is a negative word among those who remember the military creep (the ideal of liberal politicians) that was our failing in Vietnam. Failure in Vietnam resulted as politicians (amateurs in warfare) sought to control the battles. It is a negative among those who feel that it runs counter to ideology and conviction on the right. Few medical practitioners, after all, were involved in the production of Obamacare. However, before we dismiss this concept, let us understand the intent of our founding fathers.
The Constitution was conceived as a balancing act in which any of the three branches of the federal government could limit the expansion of the others. Lost in our teachings is the principle of the fourth branch in the form of the individual states through the Tenth Amendment and the respective state legislative selection of U.S. senators. This was diluted through the Seventeenth Amendment, allowing direct election of senators. The political left has used the coequal branches to collude (the real collusion through the judiciary) in expanding the role of government intrusion into our daily lives.
Our founders wanted to make it difficult to expand the power of government. Therefore, only through consensus of the governed would major changes be enacted. Our people, like most, tend toward gradual changes, not revolutionary ones. It takes a crisis (per Rahm Emanuel) to make great leaps.
In this way, the liberals or progressives have understood human nature. They seek changes aimed at government growth through incremental legislation. Occasionally, they accomplish large leaps such as the Affordable Care Act, in which the bureaucracy grows exponentially. Generally, they succeed in smaller legislative victories. But they remain united in the goal of growing the federal government.
Republicans fail to understand this principle. They fear bad press, which is committed to liberal causes, more than they fear their base. The closeness of the vote in the Senate may force some to vote for the McConnell compromise now being unveiled. Which Republican would want to be remembered for his failure to rid us of Obamacare?
The sausage being concocted is messy and devoid of complete repeal. However, any aspect of repeal is better than the present failing system. Incrementally, Republicans can correct a destructive medical funding system, or they can go to defeat in 2018, when their base will remember those who were not truthful during their campaigns. A clean repeal is preferable but unlikely.
Kentucky senator Rand Paul is firmly against the present bill, as it gives taxpayer funds to insurance companies. Maine Senator Susan Collins is firmly against the bill because it cuts increases to Medicaid funds that her state's rural-area hospitals have grown dependent upon. It is very difficult to remove an entitlement once enacted. Republicans need to understand this issue. These two politicians are different sides of the coin, but with thoughtful compromise, they might be inclined to vote for a reform bill.
Failure to compromise now will doom us to the awful specter of further erosion of our liberty and medical choices. The Democrats (including moderate W.V. senator Joe Manchin) want to fix Obamacare, which means continue the march toward socialized medicine. This is the principle on which Republicans and conservatives must not compromise. Senator Paul, not a great team player, is missing this ideal. Senator Collins is missing the opportunity for her state's medical system to innovate and solve long-term funding issues (as surely will occur when the federal debt exceeds sustainability).

Arizona senator John McCain's recent surgery has delayed any senatorial vote. Perhaps this extra time will give some courage and wisdom to those uncertain Republican senators.
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