Republican interest in health care driven by Obamacare opposition only

Philip Klein has a piece commenting on CPAC having no health sessions, and concluding that conservative interest in health policy was mostly driven by opposition to Obamacare.

Though it’s a struggle to come up with silver linings from the passage of the health care law, it seemed that, at least for a while, conservatives were becoming more engaged on the health care issue. But in hindsight, the interest in health care policy on the Right is looking more like a fad built around opposition to Obamacare. [emphasis added]

So, this is being treated as a new insight by some, but if you read this blog that goes down into the ‘no duh’ category. Here is just one fairly recent post treating this as obvious (particularly with respect to elected Republicans who would have to expend political capital to do something on health reform) and here is another. They are legion on my blog. And I think that is a really bad thing, because I think we need a deal to move to next steps after the ACA, and it takes two sides to have a deal.

Following up on yesterday’s post highlighting one part of the health reform deal I claimed in my book is what Republicans and Democrats would get to after the ACA if they negotiated based on their interests, page 60-61 of my book noted the general political reasoning of reaching such a deal (it was written prior to the Supreme Court Case):

Such a deal would make the individual mandate unneeded. It is unclear what the Supreme Court may rule about the mandate in June 2012. If it is upheld, a political deal is still needed to move ahead, and if the mandate is overturned but the rest of the law remains intact, consequential changes will be needed to achieve risk pooling. This compromise would allow President Obama and the Democratic party to take credit for compromising on their initial health reform law, and Republicans could take credit for getting rid of the individual mandate. Progressives will have achieved their long term goal of universal coverage (that the ACA as is, will not achieve), while Republicans will be bailed out from having to offer a comprehensive reform plan that can address costs and quality while expanding insurance coverage rates, which they do not have. It is telling that they made no progress toward a vision of what they were for since taking control of the House of Representatives. Without such a plan, Republicans have no hope of ever achieving a balanced budget. [emphasis added]

Just to be clear, there are some conservative intellectuals with some interesting ideas. What there appear to never have been are any elected Republicans willing to lose the next election for advancing health reform legislatively. Obamacare was always a better political issue for Republicans than an opportunity to lay out a clear alternative, because health reform that addresses coverage, cost and quality is hard. Their lack of coherence on health policy renders their top line claims about desired levels of federal spending (like a Balanced Budget Amendment with spending capped at 18% of GDP) to be absurd.

I say all this who has written a book that says what we most need to develop a sustainable budget is a deal on health reform. But again, it takes two sides (of elected officials) with a coherent position and negotiating interest to cut a deal.

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

One Response to Republican interest in health care driven by Obamacare opposition only

  1. Pingback: ACA redistribution via Medicaid: what it means for future reform | freeforall

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: