The Republican health care contradiction

Not quite sure what occasioned this from Ezra this week, as much has already said by him and others last month, but it’s a great succinct summary, so I’m going with it, too:

The most interesting policy argument in America right now is the debate between conservatives’ real position on health care and their fake position.

The fake, but popular, position goes something like this: 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, but unpopular, position on health care is quite different, and it explains their behavior much better. Their real position is that universal coverage is a philosophically unsound goal, and that blocking Democrats from creating a universal health care system is of overriding importance. To many conservatives, it is not the government’s role to make sure everyone who wants health insurance can get it, and it would be a massive step toward socialism if that changed…

There has not, in recent political memory, been a national Republican leader who actually argued that the American health care consensus was wrong and it was simply not the government’s job to ensure every American could get health insurance…

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 for decades, and so there’s no public support for the bills that actually achieve their goals. Either they need to change what they believe, and move toward the kinds of policies Roy proposes, or they need to begin the hard work of actually persuading the public that not everyone who wants health insurance should be able to get it.

Yep, yep, yep.  Also reminded me of a Chait post a few weeks ago I forgot to blog about:

But in the long run, these policy defects may be overshadowed by the ACA’s great political achievement: popularizing the idea that the government should guarantee health care to its citizens as a right.

This is not a radical idea. Every other advanced democracy arrived at it long ago, and many Americans already subscribed to the notion before Obamacare was ever introduced.

But as the Trumpcare debate illustrated, the ACA grew the constituency for government-provided health care while fostering the American public’s sense of entitlement to affordable insurance.

The GOP anticipated this development, which is why it fought so hard, on so many fronts, to kill the law. When those efforts failed, for short-term political gain, many Republicans chose not to attack Obamacare’s core premise — that the government should facilitate universal access to basic health care — but rather to attack the law for failing to realize that left-wing ideal…

The Republicans didn’t just lose the battle on health care — they lost the war.


About Steve Greene
Professor of Political Science at NC State

3 Responses to The Republican health care contradiction

  1. R. Jenrette says:

    That’s why Democrats should enthusiastically campaign on the right to health care for all.
    Just ask your Republican Congressman “Do you believe that health care is a human right or is it
    a service that money can and should buy?”

  2. rgbact says:

    Republicans popular position is that most voters care far more about lowering HC costs than endless liberal fascination with covering people that don’t really want to be covered. Thats probably where Ezra gets confused…..the “affordable” part. Hint: the current system and nothing the Democrats have come up with is “affordable”.

    • Nicole K. says:

      That’s bs. Paul Ryan is on the record explaining why he opposed Obamacare: “The idea of Obamacare is that the people who are healthy pay for the people who are sick.”

      Similarly, in 2011, after the ACA passed, then-Rep. Ron Paul (R-TX), also an obstetrician/gynecologist, was asked what should be done about an uninsured, 30-year-old man in a coma. “What he should do is whatever he wants to do and assume responsibility for himself,” Paul responded, adding, “That’s what freedom is all about, taking your own risk.”

      Or as conservative scholar Michael Strain put it in a 2015 Washington Post editorial: “In a world of scarce resources, a slightly higher mortality rate is an acceptable price to pay for certain goals—including…less government coercion and more individual liberty.”

      So let’s be clear. The GOP is against what they see as wealth redistribution in any form that it exists. The basic premise of health insurance is based on wealth redistribution. The healthy subsidize the sick. If that isn’t the way health insurance works sick people – those with expensive chronic conditions- don’t receive medical care.

      The individual market used to run the way Republicans (especially the freedom caucus) dream of it going back to. The individual market sold plans that had lifetime and yearly caps. When you hit the cap the insurance stopped paying. Imagine you are the one who needs cancer treatment and your insurance decides that you’ve maxed out and they are done with you. It’s cruel, it’s inhumane, and no other wealthy country in the world treats its citizens so harshly.

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