What is Trump going to replace Obamacare with? Speculation is rife, and Trump’s many foes are cackling. True, even Bill Clinton, as the height of his wife’s campaign, called Obamacare “the craziest thing in the world…”  But calling it crazy is one thing, dismantling and replacing it with something better is quite another.

During the campaign The Donald had very nice things to say about the quasi-socialist health care systems of other English-speaking nations. (“As far as single payer, it works in Canada,” said Trump in the course of a 2015 GOP debate, adding, “It works incredibly well in Scotland.”) Needless to say, Ayn Rand acolytes among the Republicans immediately howled, and the press soon drew attention to other political issues of cosmic import, such as Trump’s use of the “P” word in private conversation a decade ago.

Trump won, however, and as a result the crazy system Bill Clinton panned is on its way out. To be replaced with a dash of Scottish Canuck? Unlikely. One can’t simply duplicate those systems and impose them on the very different population landscapes of America.

Yet there is a simple and effective American system already in operation which only needs expansion to provide universal health: Medicare.

Is expanded Medicare, then, the Trumpcare waiting to be unveiled? John Wasik considers this question in a recent article in Forbes, and finds the idea eminently plausible. Well worth a read, the piece makes the case for universal Medicare in concise fashion, and the reason it is concise is that the case is so strong — almost obvious. There’s no need to come up with something new and complex, no need to set up or implement a completely novel and untried system. All one needs to do is expand an already functioning, already popular system. (Popular, at least, with everyone other than the insurance companies making vampiric profits from the existing, collapsing, system.)

The problem, of course, is that Trump’s chances of getting such a plan accepted by a Republican House and Senate are zero. National Health Care is national health care, and deep in the heart of every Republican politician addicted to the heroin of political donation is the awareness that supporting such a plan would dry up the flow of H from the companies profiteering from the current semi-private systems. Obamacare was a dream come true for such companies: a law requiring people to make purchases and regular payments from insurers. Neither the companies nor their politicians on the take will give that up easily.

But is it really hopeless? Wasik’s article addresses the intrinsic pluses of MFA (Medicare For All), and they are (in this columnist’s opinion) sound. The only question is whether Medicare For All is politically viable. Surprising, Trump is a factor than makes the possibility far more likely than it would otherwise be.


First, Trump is not dependent on insurers’ donations (or anyone’s donations) to any degree.

Second, his capacity to achieve goals in the teeth of Republican opposition is a matter of record. His chances of securing the Republican nomination were zero too.

Third, strong public support would be likely. Medicare is popular with those already on it, and those acquainted with them know it. Medicare For All is an idea with a grass roots sales force already in place.

Fourth, Democrats have been pressing for national health care almost as a litmus for so long that their votes may be taken as a given. Indeed a majority (if not the totality) of the Democrats would go for it purely to see Republicans gag. (For the same reasons, many a news commentator would advocate for it even if it were proposed by Trump, a killer for virtually any other proposal.)

Trump therefore would only need to turn a handful of Senate and Republican votes, not all. And that is far from unlikely.  Not a few Republicans are coming around to the New Nationalism, or at least realize that sucking up to a new President is in their long-and short-term interest.

The real question is whether Trump himself would go for it. The rational reasons why he might are cited in Wasik’s article, the principal ones being that only expanded Medicare can really deliver the quick, universal and popular criteria he’s insisted upon throughout his campaign. There really is no alternative that is not complex, slow, clunky and essentially untested.

But the MFA solution also has a stylistic aspect that I think would be very attractive to Trump. He has a gestural way of thinking, a way very much inclined toward simplicity, radicalism, unexpectedness and decisiveness. It would astonish. And The Donald likes to astonish.

In addition, supporting it would be a win-win for him politically. If it passes, he becomes a genius and hero, making history in one radical and compassionate fell swoop; and if it fails, he becomes a titan brought down by reactionary traitors within his own party frustrating the needs of the People, whose just wrath would lift him up all the more. For the Republicans have not yet grasped that their Nationalist brethren do not give a fig whether a proposal means Big Government or not; vox populi rules all. The popular rancor enveloping them if they were to bring such a deal down would make their recalcitrance a salutary lesson.

I believe Trump is seriously thinking along these lines. I don’t know whether he will go for it, though I hope he does. MFA beats what we have now, and it will certainly beat whatever malformed Frankenstein emerges from the extended give-and-take of a three-way clash between Republicans, Democrats, and Trump himself.  Given that alternative, and circumstances overall, it is the best solution for both the general population and for Trump and the Trump Administration.

But it’s worth noting in passing that he is pretty much the only person in politics that could seriously press for such a proposal, and who might actually pull it off.  A long shot, I grant you, but having been told for so long that a President Trump would plunge us into the unthinkable, it’s a pleasant surprise to see that same President perhaps expand the range of the thinkable as well.