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Trump's ignorance about health care carries real consequences

This isn't just a point-and-laugh-at-the-amateur-president moment. There are practical consequences to Donald Trump's ignorance about health care.
Image: First Lady Melania Trump Hosts A Celebration Of MilitaryMothers Event
U.S. President Donald Trump hosts an event for military mothers on National Military Spouse Appreciation Day with is wife, first  lady Melania Trump, in the East Room of the White Hosue May 12, 2017 in Washington, DC. 

A few months ago, when the House was trying to pass its far-right health care plan, Donald Trump thought some presidential pressure could help seal the deal. The president's ignorance about the basics of the debate, however, kept getting in the way.

Politico reported in March that when the president tried to lean on the far-right House Freedom Caucus, its members found Trump charming, but it became clear "that no serious changes were going to be made" during the conversations, because "the president didn't have sufficient command of the policy details to negotiate."

Trump has had ample time to get up to speed in recent months, but by all appearances, he doesn't feel like it. The president hosted a meeting yesterday with Senate Republicans -- after GOP leaders scrapped a scheduled vote on the party's far-right plan -- and some came away with the impression that Trump still doesn't know what he's talking about. The New York Times reports today:

A senator who supports the bill left the meeting at the White House with a sense that the president did not have a grasp of some basic elements of the Senate plan -- and seemed especially confused when a moderate Republican complained that opponents of the bill would cast it as a massive tax break for the wealthy, according to an aide who received a detailed readout of the exchange.Mr. Trump said he planned to tackle tax reform later, ignoring the repeal's tax implications, the staff member added.

This isn't a point-and-laugh-at-the-amateur-president moment. There are practical consequences to Trump's ignorance.

It matters, for example, that the president can't engage in meaningful negotiations with members of Congress about the legislative details. The differences within the GOP are significant, and crafting a compromise requires a detailed understanding of how the pieces to the puzzle work together. Trump simply isn't in a position to lead, not for lack of will, but because he simply doesn't have the knowledge necessary to play a constructive role.

This dynamic also affects public opinion. The Republican plan is woefully unpopular, though the effort may have more support if Trump could use his high-profile platform to sell the bill's virtues. But the president simply can't play this role -- because he doesn't understand the proposal in any detail, and he doesn't even try to defend the plan on the merits.

This is, not surprisingly, a point of some embarrassment for the unprepared president. Trump insisted on Twitter this morning that when it comes to health care, he "knows the subject well." This follows his recent boast to Time magazine that he now knows "everything" there is to know about health care.

Even the most sycophantic Trump supporters probably find this hard to believe. After all, the president has literally never demonstrated any real familiarity with the details of the debate, and accounts of his private interactions with lawmakers bolster concerns that Trump simply has no idea what he's talking about.

Either he's ignorant about the substance of health care or he's doing a remarkable imitation of someone who's ignorant about the substance of health care.

Eight years ago this week, then-President Barack Obama hosted a 90-minute public forum exclusively on health care policy, fielding questions from doctors, reporters, and the public at large. Can anyone imagine Donald J. Trump doing something similar? Does anyone seriously believe he'd want to try?

It's not too late for the president to start taking his responsibilities in this area more seriously, but I'd recommend keeping expectations low.