Sorry Fred. It will take more than teamwork to fix GOP healthcare dysfunction

GOP 2017. What a team!

Why can’t the Republican Congress manage to repeal and replace Obamacare, considering the whole party has campaigned for seven years on the promise to do just that? According to Fred Barnes of the Wall Street Journal the answer is simple: the Republicans are not playing as a team. In Barnes’ reality, if the GOP would only treat politics as the team sport it is they could create “a more free-market healthcare system in which people can buy the insurance they want, not what government requires.” It sounds so beautiful I’m sure everyone will put aside their differences and make it happen!

Alas, with two more Republican Senators coming out against the bill the same day the Op-Ed was published, it doesn’t seem that Mr. Barnes is making much headway.

But Barnes has misunderstood the real causes of Republican disarray on healthcare. For his benefit, here are some:

  • The Affordable Care Act is actually a well thought out, moderate piece of legislation, not a looney left-wing one. It contains a variety of market oriented and conservative principles that were designed to encourage Republicans to vote for it. Major facets include the individual mandate (personal responsibility, supposed to be a conservative idea remember?) and the insurance exchanges/marketplaces, where private insurers compete for business.
  • Despite what Republicans say now, there were numerous attempts to bring them into the fold in 2009 and 2010 and enact a bipartisan law. But Republicans decided to stand uniformly against the ACA, showing that there’s plenty of “teamwork” and discipline available, but only when it comes to saying no.
  • Once Obamacare was in place, Republicans did all they could to undermine it: filing frivolous lawsuits, wiping out the risk corridors, lying about death panels, blocking navigators from doing their work, and voting to repeal the law over and over again, but only when Obama was there to veto it. They’re still at it, trying to destroy the insurance exchanges even though Republicans are in charge.
  • Despite talking about “repeal and replace” they never came up with a serious “replace” approach. Most of the so-called ideas were tired talking points trotted out as though they would make a big difference: selling insurance across state lines, enacting tort reform, and promoting drug re-importation. (This is really where the term “nothing burger” should be employed.) House Speaker Paul Ryan’s undeserved reputation as a big thinker should be fully crushed by now.
  • Congressional Republicans have fallen in line behind a president who knows nothing about healthcare policy, has no idea what’s in the House or Senate bills (assuming he even knows how the legislative branch works) and promised “something terrific” but never has and never will explain what it is.

Congressional Republicans should hit the reset button. They should apologize for how horribly they’ve behaved on healthcare policy, and work with Democrats on common sense improvements to the Affordable Care Act. Instead it sounds like the new idea is just to repeal and then spend another couple years trying to figure out what replacement would be.

Truth is, Republican legislators gave up on governing to become the party of no. It worked pretty well in the short and medium term, bringing with it Congressional majorities, the presidency, and a stolen Supreme Court seat.

Now would be a nice time for the GOP to grow up. Healthcare is a good place to start, and if they put country ahead of party they’ll find plenty of Democrats to cooperate. Personally I’m not betting that will happen.

Meantime, maybe Mr. Barnes will start arguing for teamwork when it comes to raising the debt limit. Rah! Go team!

By healthcare business consultant David E. Williams, president of Health Business Group.

July 18, 2017

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