Must-Read: Ezra Klein: The GOP’s problem on health reform is they’ve spent years hiding their real position

Must-Read: Ezra Klein: The GOP’s problem on health reform is they’ve spent years hiding their real position: “The most interesting policy argument… is the debate between conservatives’ real position on health care and their fake position… http://www.vox.com/policy-and-politics/2017/4/17/15325366/gop-problem-on-health-reform

The fake… position…. Conservatives think everyone deserves affordable health insurance, but they disagree with Democrats about how to get everyone covered at the best price. This was the language that surrounded Paul Ryan and Donald Trump’s Obamacare alternative—an alternative that crashed and burned when it came clear that it would lead to more people with worse (or no) health insurance and higher medical bills.

Conservatives’ real… position… is quite different… blocking Democrats from creating a universal health care system is of overriding importance…. In the post-Obamacare world, the chasm that has opened between conservatives’ fake and real positions has become unmanageable…. On the latest episode of Peter Robinson’s Uncommon Knowledge podcast, Avik Roy and John Podhoretz have perhaps the most honest and bracing discussion… I’ve heard….

If Republicans cannot defend the idea that what is important is the freedom of the individual to make choices about how to live his life as opposed to the notion that we are all in this together and must all participate in health care to ballast each other’s health care outcomes, then we have accepted an essential social democratic principle, and that’s a huge concession.

Roy… argue[s] that this reflects a failure of the conservative imagination, and that the possibility exists to expand freedom and expand coverage while cutting costs.

It is notable… that the “conventional conservative view” is so utterly absent from the rhetoric of top conservative politicians…. Republicans carefully use terms like “universal access to health care” as a way of sounding like they’re endorsing a world where everyone has health insurance even when they’re not. Top Republicans, including Mitch McConnell, spent years arguing that the Affordable Care Act wasn’t covering enough people with sufficiently generous health insurance. Then the GOP elected Donald Trump, who promised “we’re going to have insurance for everybody” with “much lower deductibles.” And this tension predates Obamacare…. Even Ronald Reagan bowed to the consensus—his famous “there you go again” dismissal of Jimmy Carter was Reagan denying his previous opposition to Medicare….

Conservatives stopped trying to win the philosophical argument a long time ago. But they didn’t stop trying to win the policy fight. They might have talked like they agreed with Roy, but they governed like they agreed with Podhoretz—because they did. And so they used whatever rhetoric was effective…. Now that Republicans have lost on policy too, their two-step has collapsed….

Republicans need to realize their problem isn’t poor legislative leadership or dissident House conservatives. It’s that they’ve been hiding their real health care position…

April 18, 2017

AUTHORS:

Brad DeLong
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