Saturday, August 24, 2013

Health Care Matters, and Republicans Can't Get There from Here

The key to the Republicans' conundrum with health care is that Obamacare can work. Oh, they worked overtime to demonize it, but they didn't do it with the truth. So sez Jonathan Bernstein at WaPo's The Plum Line:
...Much of the initial hatred of the ACA was focused on a series of phony talking points and outright lies (“government takeover” of health care; “death panels”; the law was “rammed through” using corrupt procedural tricks; etc.).
Since none of that was true, it gave Republicans an opening: they may have stigmatized “Obamacare,” but they hadn’t stigmatized the policy ideas at the core of the law — the combination of exchanges and subsidies that actually started out as a Republican plan... In other words, as late as 2012 it seemed plausible Republicans could choose to invent a ConservaCare proposal based on Ronald Reagan Marketplaces that would basically offer a slightly different spin on the same underlying idea.
But conservatives have decided that no policy overlap with Obamacare is acceptable...
So now they've cornered themselves, in that anything that solves the health-care problems that Obamacare solves -- such as pre-existing conditions -- has to, in effect, look like Obamacare. Why? Because Obamacare is based on conservative ideas, you know, preserving the insurance structure and avoiding single-payer, keeping the free market intact.

This past week Newt Gingrich chided his party -- he's been doing that a lot recently, behaving like the professor he isn't -- for not having the replace part of repeal-and-replace. In this the Republicans jammed themselves up: When you repeal "death panels," what do you replace them with when they never existed to begin with?

Gingrich didn't leave himself much of an out, either, as Ezra Klein points out:
“If we’re going to take on the fight with Obamacare, we have to be able to explain to people what we would do to make your life better,” [Gingrich] said.
That’s a task Republicans have clearly failed at. One of the more interesting polling wrinkles of the past few years is that the persistent unpopularity of the Democrats’ signature health-care initiative hasn’t helped the GOP take the lead on the broader issue. A recent poll by the Morning Consult found a 10 percent edge for Democrats on health care. Even the conservative polling group Rasmussen continues to find a Democratic edge.
The public doesn’t like what the Democrats did. But they really don’t like what they think the Republicans will do.
Of course, as Gingrich correctly points out, the Republicans have no idea what is it is they’ll do — save for undoing what the Democrats did. But for all Gingrich’s bluster on the subject, the simplest way to understand that policy vacuum is to understand Gingrich’s pre-Obamacare health-care plan: It was Obamacare.
“We should insist that everyone above a certain level buy coverage (or, if they are opposed to insurance, post a bond),” he wrote in his 2008 book, “Real Change.” “Meanwhile, we should provide tax credits or subsidize private insurance for the poor.”
So that’s an individual mandate plus tax subsidies to purchase insurance. That’s the core of Obamacare. And it’s no surprise Gingrich supported it. Lots of Republicans did. Gov. Mitt Romney even signed a plan like that into law in Massachusetts.
Which, as you know, Romney campaigned against, however contorted he had to become. (I like my ideas except when Obama agrees with them.)

And thus we find the crazies among the conservatives attached at the hip to defunding Obamacare, while the moderates -- and thus leadership -- in the Republican Party urge a repeal-and-replace notion that they can't talk about because it would sound like Obamacare.

And, finally, that leadership is in danger of going all in with the "defund Obamacare or we bring down the world economy" blackmail because they have -- or will have -- crazies running against them in the primaries. Even if Mitch McConnell seems poised to defeat his tea-party challenger, the threat may drive him further right, as he fears what happens to his base when he cuts a deal to "preserve" Obamacare. Will his base move over to his opponent?

While Obamacare will likely take effect in October -- with Democrats getting the credit when it turns out that it works -- the extreme right might yet gamble on bringing down the government, at the risk of destroying the U.S and world economies.

It's not wise to corner wild animals. It turns out that Republicans have cornered themselves. Will they act like wild animals? Let's hope not.

Update. I had originally wanted to include a link to a horrendous Karl Rove op-ed piece about the Republican "alternative" to Obamacare, but it's behind a paywall at the WSJ. So here's a link to a takedown of it by Kevin Drum at Mother Jones. It's good, with links to other folks' responses, including Paul Krugman's. Check it out.

Oops, the truth slipped out.

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