Last week, Republican Senators Tom Coburn, Richard Burr, and Orrin Hatch unveiled a health-care proposal or, at least, a close approximation of one. Conservatives hailed it as a seminal event, the moment when the Republican Party would finally dispel the accusation of mindless obstructionism and assert its full equal status as a vessel for serious health-care policymaking. Ross Douthat rejoiced, mirabile dictu,an actual health care reform proposal! The new plan explode[s] the myth, exulted a National Review editorial, that Obamacare or something like it is the only game in town. <\/p>\n
Republicans are certainly going to have to abandon their indifference to policy and formulate an actual health-care reform policy. But the moment has not arrived, and the events since the plans hopeful emergence have made the gap between aspiration and reality painfully clear. <\/p>\n
Within hours of the new plan coming into contact with political reality, things began to fall apart. The general outlines of the plan involved deregulating health insurance, so that healthy customers paid less for cheaper plans and sicker customers paid more, and shifting the tax burden off the wealthy and onto the middle class. Defining its effects more specifically has proven difficult. Its less a plan than an outline that, depending on how the authors filled in its missing details, could mean any number of wildly different things. <\/p>\n
The first blow to its coherence came when the authors faced questions about their proposal to cap the tax deduction for employer-sponsored health insurance, a politically risky but economist-approved change that provided most of its money for covering the uninsured. Asked about this piece of their plan, the authors changed the language within hours to ratchet back its scope, insulating them from political attacks, but also neutering its value. <\/p>\n
The next thing that happened was that, on Tuesday, the Congressional Budget Office released a new budget update. The latest CBO estimate contained political gold for Republicans: It estimated that the availability of health insurance would spur workers to reduce their labor by the equivalent of two million jobs, a change Republicans could gleefully mischaracterize as destroying two million jobs. Of course any health reform plan would reduce employment this way if you give people the chance to leave the safety of employer-sponsored insurance without risking the horrors of the pre-Obamacare individual market, many of them will. The Republican proposal, sketchy though it was, would likely have approximately the same job-killing impact as Obamacare. <\/p>\n
But while reveling in the potential new attack line, Republicans suddenly forgot that they had a plan other than repealing Obamacare. What was the fun in comparing Obamacare to a specific plan, with trade-offs and disruptions of if its own, when they could continue assailing every real or imagined downside of Obamacare, full stop? <\/p>\n
Every Republican health-care reform plan in history has served the same purpose: to enable Republican politicians to say that they do indeed have a health-care reform plan, in order to block Democrats from enacting a health-care reform plan. Two of the sponsors of the new Republican plan, Coburn and Burr, also sponsored, along with Paul Ryan, a health-care plan in May 2009. It was a pretty good plan, albeit a somewhat vague one. It was based on replicating Mitt Romneys successful reform in Massachusetts in the other states. It set up health-care exchanges in every state, which would be regulated heavily. The plan, the authors wrote, prevents cherry picking when insurance companies choose to cover only healthy patients by equalizing risk across insurance companies and reversing the perverse incentives that leave those most vulnerable with the fewest options. It required that all health-insurance plans meet the same statutory standard used for the health benefits given to Members of Congress. Ezra Klein really liked it. <\/p>\n
That sounds a lot like Obamacare, doesnt it? Indeed, it does. But Ryan, Coburn and Burr did not see their plan as fertile grounds for compromise. Instead they saw it as the free-market alternative to the European, socialistic horrors Democrats longed to impose upon America. In defending their plan, they pointedly contrasted it with Obamacares public option: <\/p>\n
Nothing will rally ordinary Americans against the president's plan more than his allies arguing too forcefully for a system run by politicians and bureaucrats in Washington what we call the \"public option\" in the Obama plan <\/p>\n
If Washington can effectively run a health program like Obama's public option, why are Medicare, Medicaid, and other federal health programs in such disrepair? <\/p>\n
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Continued here: <\/p>\n
The Lonely Death of the Republican Health-Care Plan<\/a><\/p>\n","protected":false},"excerpt":{"rendered":" Last week, Republican Senators Tom Coburn, Richard Burr, and Orrin Hatch unveiled a health-care proposal or, at least, a close approximation of one. Conservatives hailed it as a seminal event, the moment when the Republican Party would finally dispel the accusation of mindless obstructionism and assert its full equal status as a vessel for serious health-care policymaking. Ross Douthat rejoiced, mirabile dictu,an actual health care reform proposal! The new plan explode[s] the myth, exulted a National Review editorial, that Obamacare or something like it is the only game in town Continue reading