Why replacing Obamacare is so hard: It’s fundamentally conservative - Craig Garthwaite, Washington Post

[TomSea]

Why replacing Obamacare is so hard: It’s fundamentally conservative

 By Craig Garthwaite July 10 at 2:22 PM

Craig Garthwaite is an associate professor of strategy and director of the Healthcare Program at Northwestern University’s Kellogg School of Management.

Republicans are engaged in a brutal civil war between hard-liners and moderates as they struggle to craft legislation to repeal and replace Obamacare. The episode invites an almost existential question for the GOP: Why, after seven years of nearly endless war against Obamacare, is the party unable to deliver a more conservative policy that provides access to health care to a similar number of Americans?

As a life-long Republican who has spent months contemplating this question, I’ve come to an answer that will be hard for many conservatives to swallow: Passing an Obamacare replacement is difficult because the existing system is fundamentally a collection of moderately conservative policies.

Continued: https://www.washingtonpost.com/opinions/why-replacing-obamacare-is-so-hard-its-fundamentally-conservative/2017/07/10/c5d64634-6351-11e7-84a1-a26b75ad39fe_story.html?tid=pm_opinions_pop&utm_term=.c79de0ca1777

[RoosGirl]

Yes, that's why all the conservative members of the republican party voted for it when it passed 7 years ago.

[Smokin Joe]

Nothing Conservative about a socialist end run around the Constitution. Nothing.

[INVAR]

Our resident Leftist will be here in the morning to trumpet this Communist claptrap too.

[Smokin Joe]

Our resident Leftist will be here in the morning to trumpet this Communist claptrap too.

LOL! Bank on it!

[Hondo69]

See the woman with two heads and the half man half alligator - only a measly two bits ladies and gents.  Step right up.

[Jazzhead]

Our resident Leftist will be here in the morning to trumpet this Communist claptrap too.

No, INVAR, I'm just the resident old school Republican.   I remember as a young man devouring the policy proposals of the Heritage and AEI folks concerning the use of an individual mandate to achieve a workable structure for community rating.   It was seen as the effective conservative antidote to single payer, by encouraging an efficient and affordable private insurance market that could cover most able-bodied adults without regard to health or employment status. 

Yes, the roots of ObamaCare are indeed conservative.   The Dem left preferred single payer, but because the Dems had to achieve unanimity within their caucus,  the ACA instead resembled RomneyCare on steroids.    That's why I've never had an ideological aversion to fixing what's wrong with the ACA rather than repealing it and returning to the bad old days when folks in their fifties who lost their jobs couldn't get health insurance at any price.   Because to return to the bad old days would be to return to the conditions that make single payer so attractive.

I admit to being surprised at the ferocity of the opposition by some conservatives to the GOP reform bills.   Both the House and Senate versions would get rid of the hated individual mandate that "forces" free riders to buy insurance,  and the employer mandate that keeps small employers from hiring that 51st worker.    Instead,  conservatives seem to have rose-colored glasses about how life was before the ACA.   Sorry,  but I have no interest in returning to the status quo ante, which was arbitrary and unjust.   

I still think the way ahead is to fix the ACA by encouraging consumerism,  offering more choice in the marketplace,  eliminating job-killing mandates, encouraging state innovation, and block-granting the Medicaid expansion so as to free up long term tax savings for use in jump-starting economic prosperity.   I still think the GOP reform bills are firmly in the conservative tradition of intelligent regulation of private markets.   

     

[Hondo69]

There is a big difference between Environmentalists and Conservationists, but most people don't understand the difference.

There is a big difference between Republicans and Conservatives, but most people don't understand the difference.

There is a big difference between Free Markets and Government Controls, but most people don't understand the difference.

I could go on and on but it wears me out.  We have a communications breakdown to the point where it is nearly impossible to have anything resembling a decent conversation.  Besides butchering the Queen's English we also fall into the Liberal trap that allows them to redefine the meanings of words at will.  For example, my brain is still recovering from someone referring to RomneyCare as a Conservative program.

A lobotomy would be less painful - but it does make for a good comparison because the effects are the same.

Stop Making Sense is not just the name of a film about the Talking Heads.

[Jazzhead]

There is a big difference between Environmentalists and Conservationists, but most people don't understand the difference.

There is a big difference between Republicans and Conservatives, but most people don't understand the difference.

There is a big difference between Free Markets and Government Controls, but most people don't understand the difference.

I could go on and on but it wears me out.  We have a communications breakdown to the point where it is nearly impossible to have anything resembling a decent conversation.  Besides butchering the Queen's English we also fall into the Liberal trap that allows them to redefine the meanings of words at will.  For example, my brain is still recovering from someone referring to RomneyCare as a Conservative program.

A lobotomy would be less painful - but it does make for a good comparison because the effects are the same.

Stop Making Sense is not just the name of a film about the Talking Heads.

Old school conservatism was different from TEA party conservatism.    Old school conservatism recognizes the role that sound public policy can play in creating the conditions for markets to flourish.   Think Jack Kemp and Ronald Reagan.   TEA party conservatism is essentially just "leave me the hell alone" conservatism.   It is pro-individual and anti-community, and in that sense is essentially nihilistic.   At least that's my opinion.   

[INVAR]

No, INVAR, I'm just the resident old school Republican. 
     

Yeah... sure you are......whatever you want to call yourself.     We however see you as antithetical to every Conservative principle we hold to on this board.

You think and post Communism and Liberal Statism, so you are not deceiving anyone on this board, no matter the lengths or pretzel logic you try to explain yourself as being other than what your own words have revealed you to be.

Yes, the roots of ObamaCare are indeed conservative.

You might as well be trying to teach us that 'From Each According To His Ability To Each According To His Need' was written by Thomas Jefferson.

IOWs, it's bullshit you're peddling as truth.


But that is what we expect from you.

[Jazzhead]

 

[Sanguine]

As if WAPO would know conservatism if they saw it.

[Jazzhead]

As if WAPO would know conservatism if they saw it.

The views expressed are those of the writer, Craig Garthwaite, not the WAPO.  The conservative intellectual roots of the ACA (and RomneyCare) are well known.   But I concede that the conservatism of folks like Jack Kemp and Ronald Reagan  - and the Heritage Foundation in the seventies and eighties - is very different than the conservatism of the TEA party.    But that doesn't mean that only TEA partiers can claim the mantle of conservatism.   There are several respectable intellectual traditions.   And there are still a few of us old-schoolers left.   

[Ancient]

Using your definition, an "old school" conservative would want a solution that solves the problem with the least amount of government influence.  ACA is in no imaginable way anything close to meeting that standard.  Going deeper, it gave government control of things it had no business in... there is no right way to do the wrong thing.

[Right_in_Virginia]

In crafting their health-care plan, Republicans have come to the uncomfortable realization that there simply isn’t much room to the political right of Obamacare for a policy that covers as many people with high-quality insurance. Furthermore, many have realized that there isn’t much political will for a bill that covers meaningfully fewer people or that places low-income individuals in insurance plans with cost-sharing elements they can’t afford.

But before I am drummed out of the party, it’s important that we consider our history. Given current rhetoric, it seems Republican leadership has forgotten that even Ronald Reagan saw a role for the government to provide quality health insurance for those who could not otherwise afford access. At the time, this wasn’t surprising because the Republican Party wasn’t dominated by the purely anti-government ideals of the House Freedom Caucus and the more conservative members of the Senate. Instead, it was a party that at its core supported a limited, well-run and efficient government.

This fact can be seen in the structure of the social insurance policies we’ve historically supported. Rather than embracing unconditional cash transfers or regressive minimum-wage increases, we supported welfare reform and the earned-income tax credit. In areas where government service is needed, we’ve supported the expanded use of government contractors and outsourcing rather than an ever-growing leviathan.

https://www.washingtonpost.com/opinions/why-replacing-obamacare-is-so-hard-its-fundamentally-conservative/2017/07/10/c5d64634-6351-11e7-84a1-a26b75ad39fe_story.html?tid=pm_opinions_pop&utm_term=.a8db95c28d43#comments

[INVAR]

It is not the function and purpose of the federal government to "provide" anything except national defense and the general welfare of the nation - not provide welfare generally.

Using the government to put a gun to the heads of Americans and rob them of their wealth to redistribute and provide for the 'needs' of others, is Marxism - pure and simple.  FROM each according to their ability - TO EACH, according to their need.  That's what this entire discussion boils down to.  Using government to forcibly rob from those with wealth so it can be given and redistributed at government discretion TO EACH, according to their need, as government defines need.

I don't give two whits if Reagan was all-for government subsidized health insurance for the poor.  Government has proven that whatever it touches, it turns to shit and grows that shit into a monstrous pile they force all of us to eat for eternity.

Using government to do charity is not the purpose of government, and robs the individual from their personal obligation to do charity themselves and make provisions for their dependents.  They will simply divest themselves of the responsibility and shove it on the shoulders of the taxpayers.

It is past time to abolish the forms to which we have become accustomed.

[Right_in_Virginia]

,,,./It is past time to abolish the forms to which we have become accustomed.

You'll need these ....

[jmyrlefuller]

Using government to do charity is not the purpose of government, and robs the individual from their personal obligation to do charity themselves and make provisions for their dependents.

So, pray tell, if not government, who enforces that "personal obligation?"

Unless you're counting on that Second Coming happening in your lifetime, which every other prophet who claimed as such has been proven wrong, nobody does. Ergo, there is no obligation.

[GrouchoTex]

Using government to do charity is not the purpose of government, and robs the individual from their personal obligation to do charity themselves and make provisions for their dependents.  They will simply divest themselves of the responsibility and shove it on the shoulders of the taxpayers.

It is past time to abolish the forms to which we have become accustomed.
[/quote]

I am amazed at how many people on this forum are discounting this notion.

It is one of the most basic conservative tenets!

I knew that things have been shifting leftward recently, but this far?

The constitution spells out the role of the Federal Government, and it has nothing to do with us sending them money to redistribute as they deem appropriate.

[Hondo69]

Using government to do charity is not the purpose of government, and robs the individual from their personal obligation to do charity themselves and make provisions for their dependents.  They will simply divest themselves of the responsibility and shove it on the shoulders of the taxpayers.

 

I find it odd that we know what works and what doesn't work, yet we pretend we just don't know.

If we've tried A before and we've also tried B before, it's not rocket science to determine which is better.  I've tried putting my hand near a hot stove and I've tried keeping it away.  I can tell you with 100% certainty which I like better.  Oddly, many people cannot.

[Jazzhead]

Using your definition, an "old school" conservative would want a solution that solves the problem with the least amount of government influence.  ACA is in no imaginable way anything close to meeting that standard.  Going deeper, it gave government control of things it had no business in... there is no right way to do the wrong thing.

But I'm not advocating for the ACA.  I'm advocating to fix the ACA,  to bend it in a more conservative direction:

 - By encouraging more choice in the marketplace

-  By encouraging consumerism

-  By eliminating job-killing mandates and addressing free riders by means of premium differentials

-  By pricing policies so the young do not have to be unfairly burdened.

-  By block-granting the Medicaid expansion

All of these reforms are consistent with conservative tenets.   All represent a substantial improvement on the ACA.   

[INVAR]

Using government to do charity is not the purpose of government, and robs the individual from their personal obligation to do charity themselves and make provisions for their dependents.  They will simply divest themselves of the responsibility and shove it on the shoulders of the taxpayers.

It is past time to abolish the forms to which we have become accustomed.

I am amazed at how many people on this forum are discounting this notion.

It is one of the most basic conservative tenets!

Not any more. 

We have been fundamentally transformed to great applause while Liberal/Marxist Statism is being heralded as Conservatism by those who self-identify as Conservatives and Christians.

It is revealing that when you paraphrase actual segments from the Declaration of Independence, "Conservatives" ridicule it and toss up pics of ruby slippers. 

The rot is complete.

[GrouchoTex]

Not any more. 

We have been fundamentally transformed to great applause while Liberal/Marxist Statism is being heralded as Conservatism by those who self-identify as Conservatives and Christians.

It is revealing that when you paraphrase actual segments from the Declaration of Independence, "Conservatives" ridicule it and toss up pics of ruby slippers. 

The rot is complete.

If this were another forum, I might understand, but this is TBR.

Are we all now just "better" Democrats/Liberals, the "we do big Government better than they do" crowd?

 

[RoosGirl]

If this were another forum, I might understand, but this is TBR.

Are we all now just "better" Democrats/Liberals, the "we do big Government better than they do" crowd?

 

Because there are people here who will call themselves conservatives, except they divide themselves out further to being fiscal conservatives.  They are too "pragmatic" to be social conservatives.

[Free Vulcan]

But I'm not advocating for the ACA.  I'm advocating to fix the ACA,  to bend it in a more conservative direction:

 - By encouraging more choice in the marketplace

-  By encouraging consumerism

-  By eliminating job-killing mandates and addressing free riders by means of premium differentials

-  By pricing policies so the young do not have to be unfairly burdened.

-  By block-granting the Medicaid expansion

All of these reforms are consistent with conservative tenets.   All represent a substantial improvement on the ACA.   

This doesn't go nearly far enough, particularly not if you are still putting pre-existings into the regular pool and forcing cadillac plans on Americans.