More on do Republicans have a replace plan?

John Goodman pushes back against arguments that Republicans don’t have a health reform replace plan as I wrote yesterday (Ezra Klein similarly, and Kevin Drum glancing off of Klein).

It is easy to write a paper in Health Affairs, a white paper, or even a draft bill that you never take into a committee to mark up and have scored (like the Patients’ Choice Act, that has been around since May, 2009). It is hard to invest political capital in pushing such a bill through the committee structure of both house of Congress and then passing it in both and getting the President to sign it. There is no historical example of Republicans driving any sort of comprehensive health reform (I would define that as something that addressed coverage expansion and addressed cost and quality). It may well be that in the future this will change, but by default we only know what Republicans are against (whatever Dems are pushing), and at some point they will have to decide what they are for and take action to implement it. Or not.

The tax rates that most Republicans claim to desire long term have no chance of producing anything near a sustainable budget without profound health reform. And health reform will require 218 votes in the House, 60 in the Senate and 1 in the White House; without this, they cannot achieve their ultimate goal. Are they the last to realize this?

About Don Taylor
Professor of Public Policy at Duke University (with appointments in Business, Nursing, Community and Family Medicine, and the Duke Clinical Research Institute). I am one of the founding faculty of the Margolis Center for Health Policy, and currently serve as Chair of Duke's University Priorities Committee (UPC). My research focuses on improving care for persons who are dying, and I am co-PI of a CMMI award in Community Based Palliative Care. I teach both undergrads and grad students at Duke. On twitter @donaldhtaylorjr

2 Responses to More on do Republicans have a replace plan?

  1. steve2 says:

    I have read John regularly for quite a while. In his own posts, he noted that the GOP never got behind the McCain plan. He noted that many did not even understand the plan. I think it would be fair to say that there was a McCain plan, but not a GOP plan. They still dont have one, and I am skeptical they will anytime soon.

    Steve

    • Don Taylor says:

      @steve2
      yes. And often folks will say ‘this is a conservative plan’ or ‘this is a libertarian plan’ and that is not same as GOP. Problem is, you have to have a political party buy in and willingness to push to achieve anything requiring legislation.

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