By David Harsanyi
Friday, January 06, 2017
So #MakeAmericaSickAgain is the slogan Democrats cooked
up to oppose Republican health-care reform efforts. That’s because, as you may
recall, before 2010 America’s streets were strewn with the bodies of the
neglected and dead.
Since Democrats are focusing their campaign on the myth
that Obamacare is working for most Americans, it’s imperative they create the
impression no viable alternative exists. After all, it’s been nearly a week
since the new congressional session started, and Republicans still haven’t produced a comprehensive
plan to replace a massive federal health-care law.
The New York Times’
Nicholas Kristof leaves a blank paragraph in his column to illustrate what a
Republican “plan” to replace Obamacare will look like, before indulging in the
customary “people will die!” scaremongering. (Kristof’s newspaper, by the way,
featured a piece headlined “Republicans’ 4-step plan to repeal the Affordable
Care Act” the same day his column ran.)
Now, if by “plan,” Kristof is using the contemporary
Left’s definition, meaning a expensive, constricting federal regulatory scheme
that forces Americans to participate through a series of mandates, then one
hopes Republicans never have a “plan.” If the word “plan” still means “a
proposal for doing or achieving something,” the GOP have many.
Although there may not be space in either of Kristof’s
truth barrels to mention this
proposal put forward by the speaker of the House, or the numerous other
conservative plans that have been floated, they do exist even if he doesn’t
approve. Figuring out a way to turn them into legislation that can pass both
houses and meet the approval of a new populist president (who, by the way,
isn’t even in office yet) will probably take more than a couple of weeks.
You can have plans. And they can change. I know this
because Democrats had many big plans in 2008 but they did not have a finished
bill ready to go on day one. This, even though they’d been talking,
campaigning, and promising to reform the health-care system for decades. When
running for president, Barack Obama (supposedly) opposed the idea of an individual
mandate — the device on which Obamacare’s rickety viability hinges — yet it was
only later part of the plan. While he was changing his mind, the Senate Finance
Committee held 31 meetings to develop Obamacare specifics.
Democrats also had to drop the “public” option and
rejigger their abortion coverage to make the bill politically palatable for the
moderates in their own party — not the GOP. Even after this the Democrats, who
passed the basic structure of Obamacare without having to worry about any Republican
opposition, were only later forced to use reconciliation to make it acceptable
for the House.
Perhaps Republicans are embracing a newfound competence
by avoiding those political pitfalls. Perhaps they’re looking for consensus on
timelines and specifics that will make it more feasible. Most likely, it’s
going to be messy again. It’s not unprecedented.
Of course politicians grapple with the reality of power.
Democrats have grappled with the failure of their policy promises for six
years. Paul Krugman, like everyone else perpetuating the myth that there are no
replacement plans, act as if coverage can only exist through fake state-run
exchanges or welfare.
Don’t worry, though; today’s “they have no plan!” is
tomorrow’s “that plan is extremist!”
It is worth reiterating that the replacement plan doesn’t
have to be conceptually or functionally similar to Obamacare, no matter how
often the Paul Krugmans of the world demand it. The comprehensiveness and
rigidity of Obamacare are things to avoid. So replacement plans can be passed
piecemeal.
For instance, the GOP can start by overturning the
“nondiscrimination rule” that assaults religious freedom. They can get rid of
the individual mandate. They can cut funding to abortion mills. They can
deregulate to bring down costs and grant waivers that allow states to innovate
in ways previously closed to them. Democrats demanded change overnight. The GOP
doesn’t have to do the same.
In the end, though, Republicans will have to sell the
American people on market-based solutions. They will have to contrast that
vision with the top-down economics adopted by the Left. They will likely adopt
some of the more popular aspects of Obamacare (ones they’ve consistently
supported) like coverage for preexisting conditions. I’m not sure how they plan
to pay for it without a mandate (maybe Republicans can raid Medicare like
Democrats did to offset the costs?), but if the tradeoff is deregulation of
Obamacare’s most intrusive components, it would be worthwhile in the long run.
They will also deal with the difficult political task of
reforming a massive expansion of Medicaid (the vast
majority of Obamacare’s “newly insured” are actually new welfare
recipients). They will have to answer Kristof’s claims that “millions of
Americans will lose insurance, and thousands more will die unnecessarily each
year because of lack of care.” Republicans will have to convince voters that
opening up affordable and competitive markets without coercion is preferable to
preserving unsustainable state-run programs that grow in perpetuity.
Whatever the resulting plan looks like, though, from here
on in Republicans own health care. And if the GOP fails to repeal Obamacare, it
will be a function of incompetence and spinelessness, not a lack of ideas.
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