The Media's "Republicans Have No Obamacare Replacement" Myth
Of all the absurd memes repeated by the policy-bereft media these days, the idea that Republicans have no plan to replace Obamacare is one of the most irritatingly false. Here’s the latest example at Politico. Keep in mind how bizarrely ignorant this piece is by considering this context: it would’ve been as absurd to claim that Democrats had no plan for health care in 2009 because there were bills introduced with key elements differing, and occasionally clashing, with each other - or saying they had no plan in the summer of 2008 because Barack Obama's plan was only bullet points on a page, not legislation.
A legislative process inevitably involves internal negotiation and give and take between the ideal and the feasible, and should Republicans have the opportunity to pass something after November, that’s exactly what they’ll do.
What’s more, there’s far more agreement internally in the Republican Party on the broad strokes of this replacement than there was in the Democratic Party at this point in 2008, when Hillary Clinton and Barack Obama were slamming each other openly about the individual mandate and the public option was a single line in a campaign white paper.
Regardless of what the Romney campaign proposes to do on health care, Congressional Republicans know what they want to do. Here are eight things they agree about:
- They want to end the tax bias in favor of employer-sponsored health insurance to create full portability (either through a tax credit, deductibility, or another method);
- They want to reform medical malpractice laws (likely through carrot incentives to the states);
- They want to allow for insurance purchases across state lines;
- They want to support state-level pre-existing condition pools;
- They want to fully block grant Medicaid;
- They want to shift Medicare to premium support;
- They want to speed up the FDA device and drug approval process; and
- They want to maximize the health savings account model, one of the few avenues proven to lower health care spending, making these high deductible + HSA plans more attractive where Obamacare hamstrung them.
This is a picture of broad agreement throughout the caucus on numerous health policy issues – the only real disagreements are about how to achieve these goals, not what the goals are. But what’s notable about this approach is that unlike PPACA, you don’t need the Rube Goldberg-like assemblage of a 2,700 page bill to do it. You can do this in fifty pages, as Rep. Paul Broun does (he also reforms EMTALA, too!), or you could break them up and pass them separately. You don’t have a situation where pulling one block out makes the rest collapse, as we’re seeing even now in the arguments over states passing on the Medicaid expansion. Journalists who say this more gradualist approach to reform means there is no plan betray their ignorance or their bias or both.
Oh, and here are twenty-seven pages of health care bills Republicans introduced in this Congress – some comprehensive reforms, some partial. These are some of the best ones.
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Comments:
Jun '10
Re: The Media's "Republicans Have No Obamacare Replacement" Myth
But, where is the death pa...oops...best-medical-practices committee?
Apr '12
Re: The Media's "Republicans Have No Obamacare Replacement" Myth
In regards the title: The media is just echoing the messages of their Supreme Lord.
Why is there not a plan to stimulate the training of more Dr.'s and medical professionals?
A few years back I read of a medical school in NY that cut 200 seats, ostensibly to limit competition in the field.
Re: The Media's "Republicans Have No Obamacare Replacement" Myth
Highlama: In regards the title: The media is just echoing the messages of their Supreme Lord.
Why is there not a plan to stimulate the training of more Dr.'s and medical professionals?
A few years back I read of a medical school in NY that cut 200 seats, ostensibly to limit competition in the field. · 4 minutes ago
Current government policies - bipartisan ones - artificially restrict the number of doctors. There will certainly be negotiations about adding something rolling that back into new legislation, but there are differences of opinion about that, and the AMA remains a powerful lobby. But again, that's something which could be a standalone bill, unrelated to the rest.
Jan '11
Re: The Media's "Republicans Have No Obamacare Replacement" Myth
These are the same people who can't grasp the difference between opposition v. obstruction. When they're in the minority, they're exercising their sacred right to dissent; when they're the majority, others are just obstructing them.
Note: this was the subject of James Taranto's Best of the Web last night. (I highly recommend.) The Left can only discuss matters on their own terms. That leaves them with political mantras like ...
Where is the Republican proposal for a budget? Oh wait ...
Oct '10
Re: The Media's "Republicans Have No Obamacare Replacement" Myth
This is interesting short-term tinkering, but I wonder if there is an emerging consensus on the long-term fix to the mess that medical care has become in every western country.
Obviously such long-term thinking cannot be expected from congressfolk, but perhaps denizens of think tanks in the heartland have been thinking in this direction.
Dec '10
Re: The Media's "Republicans Have No Obamacare Replacement" Myth
Point 3 still strikes me as a federal takeover. Different states have different requirements for what is sold in their borders as health insurance. I doubt if people in Mississippi want legislators from California telling them what is allowed to be sold in their state.
Oct '10
Re: The Media's "Republicans Have No Obamacare Replacement" Myth
The other one I've heard is that the Republicans don't have an alternative, because Obamacare was the Republican alternative!
Mar '11
Re: The Media's "Republicans Have No Obamacare Replacement" Myth
It's not that the Republicans don't have a plan to improve health care, but rather that they haven't given any impression of wanting to pass their plan.
While it might be too early to get anything passed now, this an election year, and Republicans in Congress should be talking about what direction they want to take healthcare in post-Obamacare. But I never hear any politician mention any of the items on Ben's list (except perhaps tort) - the most any Republican seems to do is mention Paul Ryan while studiously avoiding what his Medicare reform would actually do.
Having a plan means nothing if you pretend it doesn't exist in an election year.
Edited on July 12, 2012 at 5:19pmRe: The Media's "Republicans Have No Obamacare Replacement" Myth
I'm open to this critique myself, but under most of the proposed methods, the states would still be able to decide whether out of state plans have to abide by their own regulations - as Georgia and a few other states already have.
Re: The Media's "Republicans Have No Obamacare Replacement" Myth
Mendel: ...But I never hear any politician mention any of the items on Ben's list (except perhaps tort) - the most any Republican seems to do is mention Paul Ryan while studiously avoiding what his Medicare reform would actually do.
Edited 49 minutes ago
Most of the physicians in Congress talk about this every day and week. Head over to the Republican Doctor's Caucus to see.
Nov '11
Re: The Media's "Republicans Have No Obamacare Replacement" Myth
First, goals alone do not constitute a plan. A goal is where you want to go. A plan is how you get there. A goal to reach Mars is not a plan for how to fly there. A plan must describe how to reach the goals. If there is "real disagreement" within the GOP about "how to achieve those goals," there is no GOP plan.
Second, even if Congressional Republicans collectively share coherent goals and agree how to reach those goals, the GOP will remain deservedly vulnerable to the charge it has no plan unless and until its standard bearer takes the lead to establish or endorse a consensus within the GOP leadership (inside and outside congress) about a specific plan with sufficient details (goals and how to accomphish them), commits that plan to writing, and sells it to the rank and file.
Why has Romney failed to complete this obvious necessary task? Santorum answered that question.
Edited on July 12, 2012 at 7:51pmDec '10
Re: The Media's "Republicans Have No Obamacare Replacement" Myth
Ben Domenech
I'm open to this critique myself, but under most of the proposed methods, the states would still be able to decide whether out of state plans have to abide by their own regulations - as Georgia and a few other states already have. · 4 hours ago
My understanding is that any insurance company can sell in any state they want provided they are willing to offer the product prescribed by the state and file the proper paperwork. Avik Roy discussed it in Forbes a couple of months ago. The only end result I can see is states like New York being forced to underregulate for what they think is the good of their citizens while lower cost states like Utah are required to overregulate what they want to do for theirs. I have a tremendous amount of study to do to understand any of it.
May '10
Re: The Media's "Republicans Have No Obamacare Replacement" Myth
Block granting Medicaid (like block granting anything) simply give the state pols a bucket of money to play with however they wish. Mainly by creating a bunch of upper-middle income sinecures for some connected buddies, and the opportunity to let contracts to other connected buddies.
That's how it works here in the Peoples Republic of Illinoistan anyway. Those of you who live in less corrupt states (which is any one of the other 56 states) may believe your politicians are different, but that would not be the way to bet.