The politics of health care

In trying to explain why Romney has been left standing at the curb with "RomneyCare," The Corner's Stephen Spreuiell seems to have forgotten to put the appropriate intellectual gloss over the fact that Republicans uniformly oppose a health care reform bill that, ostensibly, they would have supported in 1994.

When the Clinton task force unveiled its plan a few months later, it had combined a little from column A and a little from column B into a hybrid plan that the public ultimately rejected. But at the time, that outcome was far from certain. In a December 13, 1993 piece titled "Contrasting Conservative Plans" (columns C and D above), John Hood wrote that one advantage of the Heritage plan over the Gramm plan was its political feasibility as an alternative to Clintoncare: "By failing to guarantee universal coverage and by letting insurers charge higher prices in the initial underwriting stage to people with pre-existing illnesses or disorders, Heritage defenders say, the Gramm plan fails the first test of reform: Will it pass a nervous Congress and satisfy the demands of the American people?"

What happened in the intervening period is that the political center of gravity shifted to the right on this issue. Republicans looked to the town halls, the tea parties, and the polling on Obamacare and concluded that they could safely oppose the entire concept of compulsory insurance coverage and offer a different direction on health care — one more closely aligned with column D above and centered on attacking the cost problem first. Compulsory insurance would not be necessary, after all, if insurance were something most people could afford to buy on their own.

Most Republicans and conservatives who once supported the individual mandate moved to the right along with the rest of the public. As Sen. Orrin Hatch explained in a post on Critical Condition:

To be clear, I supported [the individual mandate as an] alternative to President Clinton's massive federal takeover of the American health-care system, because my number-one priority was the defeat of yet another big-government assault on health care that the people of Utah overwhelmingly opposed. It's that simple.

In the intervening years, I went back and carefully examined, in close consultation with constitutional experts, the legal problems with many of the bills being supported at the time. This needed to be done, because of the hasty nature of the debate which was thrust upon us in 1994. It is simply a fact that Congress has never imposed this kind of mandate before. We concluded, as would any intelligent scholar of the Constitution, that this federal mandate requiring Americans to either purchase health insurance or face a punitive tax exceeds the authority the Constitution has given to Congress.

The Heritage Foundation has adopted this same position, as Robert Moffit explained in an op-ed for The Washington Post yesterday: "Our research . . . has led us to realize our initial idea was operationally ineffective and legally defective," Moffit wrote. "Well before Obama was elected, we dropped it."

Wait, did they look to the polls or consult with (unnamed) constitutional "experts?" And during the last long summer of tea parties and town halls, how come Republicans didn't offer an alternative plan focusing on health care costs and lowering the price of insurance? I mean, if their ideas were so poll tested, popular, "operationally effective and legally...un-defective" than surely they would have scored tremendous points with a skeptical public by showing they really do have "ideas" about "heath care" and "reform."

Instead, what they really want to do now, should they regain control of Congress, is to "repeal" the "bad stuff," i.e., the cost control elements of the bill (such as the individual mandate) and keep the "good stuff,"such as the ban on rescissions and refusing coverage based on pre-existing conditions. And, oh yeah, billions of dollars to the states. You know, the stuff that will drive up the cost of health insurance.

As with the Plan D drug benefit, they're fine with showering voters with benefits (just don't mention "donut holes"), but paying for them...shit, that's for suckers.