Howard Cohen, who lives in North Hills and has Medi-Cal coverage, likes getting worked up about things, and healthcare reform gave him a nice fat target.

According to a poll, he told me by email Friday afternoon, support for Trumpcare was running at only 17%. Trump’s support, meanwhile, was about twice that, which put the president in a relatively weak position, by Cohen’s estimation.

“He cannot persuade a dog to bark,” said Cohen, who calls himself “the best political analyst you’ve never heard about.”

Cohen, who is full of ideas, had one for House Republicans who wouldn’t sign on to Trumpcare because it wasn’t draconian enough.


“In a cost-benefit analysis, they’re better off rounding up and shooting the poor and infirm,” said Cohen.

I hope they pay Cohen an appropriate fee if they follow his advice, but for now, it doesn’t look like there’s much of a plan following the remarkable belly-flop Trump took on Friday.

You know the back story, of course.

“You will end up with great healthcare for a fraction of the price and that will take place immediately after we go in,” Trump promised in one of his stump speeches on the campaign trail.


But he wasn’t done. He added three more words for emphasis.

“Immediately!”

“Fast!”

“Quick!”


He said that in Las Vegas, in February 2016, and I point out the date to set up a question.

In the year that followed, might it have been prudent for Trump to actually come up with a reform plan? Might it have been worth the time of Republican leaders to do the same during years of bashing Obamacare and staking their careers on a vow to get rid of it?

Instead they produced a dud of a bill. Doctors didn’t like it. Nurses didn’t like it. The AARP was one of the biggest critics, because some seniors would have taken a beating.

“It’s horrific,” Los Angeles Dr. Lynn Goodloe told me Thursday when I asked what she thought of the impact on mental health care.


Goodloe is co-founder of the urban Los Angeles chapter of the National Alliance on Mental Illness, and she has a son who is severely mentally ill.

Like so many families dealing with mental illness, the Goodloes have been through hell. But under Obamacare, mental health coverage was listed as one of 10 essential health benefits insurers had to provide. Goodloe said the mental health system still has plenty of room for improvement, but that was a step in the right direction and cause for celebration.

For the so-called Freedom Caucus of the Republican House, it was a step in the wrong direction, and cause for rebellion. The freedom fighters couldn’t stomach the other essential benefits, either, which include coverage for emergency services, hospitalization, maternity and newborn care, prescription drugs, laboratory services, chronic disease management and pediatric services.

You know, the kinds of things that are covered in civilized, humane societies.


I met a woman two weeks ago outside L.A. County-USC Medical Center, where I was reporting on the expected impact of Medi-Cal cuts in the reform bill. She told me she was a Medi-Cal patient, with physical and mental health issues, but she wasn’t too worried about losing her coverage.

Why not? I asked.

Because, she said, she intended to commit suicide anyway.

She looked at me and said not to worry, then pointed to a tattoo on her right arm.


It said, “Not Today.”

Then she smiled and walked away.

“That’s a shame,” said Roxanne Campbell, who was in a medical wheeler/walker and overheard the conversation.

Campbell said she was a court reporter who took ill and has had three strokes. Like so many others who can’t afford health insurance, Medi-Cal and the services of a great public hospital like County-USC are a lifesaver, literally.


I had gone to County-USC to shadow Dr. Jonathan LoPresti, who’s been there for 36 years. The Congressional Budget Office had said Trumpcare would leave millions of people without insurance, while others would pay more for less care. LoPresti had contacted me to say the result would be devastating, with people avoiding healthcare until they were so sick, they went to the emergency room.

The failure of Trumpcare was good news Friday at County-USC.

“The plan just wasn’t very good,” said LoPresti. “There’d be higher premiums, less healthcare, and people wouldn’t come in because they’d have to pay too much out of pocket. They would have delayed what we consider preventive and routine care.”

I’m not sure Trumpcare’s flop was the worst thing that could have happened to the president. What if the House had given thumbs up?


After months of promising better and cheaper healthcare, how was Trump going to face the millions of people who got stiffed, many of whom believed him?

As it was, the president smugly claimed that he didn’t lose on Friday, nor did the Republicans who crafted the bill.

The real losers, he said, were the Democrats. Namely New York Sen. Chuck Schumer and Rep. Nancy Pelosi of California, because you knew Trump had to blame someone from California.

It’s not as if Obamacare is perfect, by the way. While there were millions of winners, a lot of people ended up with higher premiums or fewer healthcare options or both. A man of humility might have said we should try to improve on the existing plan, but on Friday Trump said nothing can be done, so he intended to stand by and watch it explode.


We are not so cynical as that in California, where several million people got health insurance under the Medicaid expansion. That’s expensive, but it was both a moral choice as well as a dollars and sense consideration.

“Nobody knew health care could be so complicated,” Trump said a few weeks ago, when he first sensed he was writing a sequel, the Art of the Debacle.

We did. We knew it even when Trump gloated, after his election victory, that Obamacare was history.

“It will be repealed and replaced,” he said, cocksure as a man can be. “And it’ll be great healthcare for much less money. So it’ll be better healthcare, much better, for less money. Not a bad combination.”


Get more of Steve Lopez’s work and follow him on Twitter @LATstevelopez

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