How long can the Republicans keep up the pretense that they plan to come up with their alternative health-care-reform plan? I’m going to go with “forever.” Robert Pear and Jonathan Weisman report in today’s New York Times that the party is really working hard on that alternative plan:
Republicans say they will have to make good on their pledge to replace the health care law if the Supreme Court strikes down any significant parts of it.
If there’s a market to go short on that possibility, I would like to bet my whole net worth on it.
Let’s review a little of the history. In 1993, Bill Clinton tried to reform health care, and it appeared a strong enough threat that Republicans devised their own plan in response. It was a great way to send the message “we have a plan, too.” When Clinton’s plan collapsed, he made feelers toward the GOP plan, but Republicans turned against it, promising instead to start over in the next Congress.
For the next sixteen years, Republicans did zero to advance the cause of comprehensive health-care reform. In 2009, President Obama started working on health-care reform, and Republicans again insisted they really truly did want to reform the health-care system, just not in this particular way. Plan? TBD. Then they won control of the House and promised to immediately get to work on a replacement plan. Result: zero. Evidence of any progress toward said plan: zero.
Today the conservative Washington Examiner interviews courageous budget wonk Paul Ryan on the prospect of a GOP health-care plan. Ryan explains there just isn’t enough time anymore to come up with a Republican plan:
“Now, we’ve got nine weeks of session left. Do we want to cram through our own 2,700 page vision? No, that’s what the country hated.
Yes, okay, but why not start coming up with a plan now, so that if you win the election you’ll have something you can implement next year? Republicans have been saying for three years now that they can’t be rushed on health-care reform. If you never start work, then you can deflect any question about when you intend to finish by insisting that you refuse to cram.
Reforming health care is politically hard. It’s a huge, inefficient system, and any reform has to move around resources and shake things up in a way that people don’t like. That’s why it’s so hard to reform health care, and so easy for an opposition party to stand on the sidelines and stir up fear at any reform effort.
And this underscores the other huge barrier to health-care reform: covering the uninsured requires resources. Except for the young and healthy who choose to forgo insurance, those who lack insurance are either poor or sick. It costs more to insure them than they can afford to pay. Insuring them means somebody has to cough up money.
Republicans don’t want to cough up money to cover the uninsured because they have more important uses in mind. In the same interview, Ryan says maybe Republicans will reform the deductibility of health insurance: “On tax treatment of health care, some of our folks really like deductions, others like the tax credit route.” That sounds like a possible first step. Except the Ryan budget already assumes that it will close trillions of dollars in tax deductions like that for employer-provided health care, and then it plows all that revenue back into lower tax rates. So, no money for tax credits or any other way to support health insurance.
The Times article describes any number of reform elements that Republicans like. There will always be ideas floating around that you can refer to if you’re a Republican who wants to prove that he really cares about health reform. What there is not, and won’t be as long as anything resembling the current orientation of the GOP persists, is an actual Republican plan that covers the uninsured.