trump_ryan
© AP Photo/Evan Vucci
Exactly two weeks ago, this author predicted the defeat of the American Health Care Act — and explained that it was a step towards the final, actual deal that will repeal and replace Obamacare.

President Donald Trump faces three irreconcilable factions: the GOP establishment, conservatives, and Democrats. He must bring them together — to "deliver the goods," a key rule in The Art of the Deal. But first he must show them "the downside" — and convince them they will fail on their own.

The most difficult faction to deal with is the Republican establishment — not because they are politically strong, but because on policy issues like health care, they are convinced that they have all the answers and that Trump just does not understand.

So he let them make the first move — and he exposed two things about them: first, that they had not come up with a plan that was ready for prime time; second, that they had not done any of the political legwork necessary to sell their plan to voters.

Trump gave Speaker Paul Ryan and the House Republican leadership enough rope to hang themselves. Instead of dictating terms to him, they will now depend on him to save them, politically. They must accept whatever plan he will put forward.

But Trump will not make the next move. He will let the conservatives move first. They are the big winners in the first round — much more so than the Democrats, who are enjoying the spectacle of Republican dysfunction but have no role to play yet.

The conservatives will proceed with their demand for a full repeal of Obamacare. And then they will face the ire of voters who are deeply unhappy with Obamacare but upset about losing the paltry, expensive health insurance they currently have.

That, too, will strengthen Trump, and convince conservatives they need his leadership.

Whereupon Trump will turn to the moderate Democrats and offer them a deal — perhaps catastrophic health coverage in exchange for repealing Obamacare.

Democrats would take that deal because they would see a government-backed catastrophic insurance system as a possible path to the universal health care system of their dreams. Republicans would take that deal — after exhausting all of the other options — because it would leave enough room for the free market to provide insurance for most health issues, and for states to experiment with their own policies. And the more health care stakeholders who can be brought into the process, the better.

To quote Morpheus, from the Matrix Reloaded: "What happened, happened, and couldn't have happened any other way."