Sympathy for the Devil: Conservatives and the Healthcare Conundrum
The Wrong Side...
It is not often that I feel a pang of sympathy for the Conservative plight, and why should I? In my life time the GOP has stood on the wrong side of essentially every social issue of consequence. They stood firmly against gay marriage, firmly against abortion, firmly against helping with the refugee crisis, firmly against the separation of church on state on a plethora of different occasions. In the decades prior to my birth the history books tell me they stood on the wrong side of essentially every social issue that came before. They stood against Miscegenation, they stood against the Civil Rights Act, they stood against Women’s suffrage.
While the Conservative caucus and/or the GOP has, on occasion, had a regulatory or economic position I was at least somewhat receptive to, it has been the case on every ballot that I have had an opportunity to cast that a vote for those regulatory or economic measures that do make sense to me was also a vote against the basic rights of people that I care about. Selling out the rights of my friends and loved ones for a potential economic gain has always seemed to me a villainous thing to do.
A Sweeping Victory
Not to mention the GOP just won a sweeping victory. They have a President their conservative base was crazy about. They control both houses and Congress. They control the Supreme Court. They have literally every political advantage they could possibly want, with the ability to pass any legislation they please without needing a single Democratic vote. Able to run the nation as they will despite all of the silly Democratic and Liberal complaining.
And yet I do pity them, for they are slowly being hung by a rope they themselves twisted. I pity them for the impossible corner they’ve written themselves into with Obamacare.
What a Mess
Unless you’ve been living under a rock for the last 6 years, you know that there is literally no issue that has been campaigned on by Republicans more heavily than the repeal of Obamacare. There has been no rhetorical extreme the party was not willing to go to in order to undermine and diminish the signature legislation of President Obama. Think of the most overblown, hyperbolic, and ridiculously exaggerated criticism of Obamacare you can possible imagine: I assure you some elected Republican has made that criticism with a straight face an no intended sarcasm... probably more than once. The repeal of Obamacare has been the towering monolithic issue of the Right for the past two election cycles, the coal in their Political furnace. Now they have complete control of Congress and a President who will sign a bill if they put one on his desk.
So what is the hold-up?
The GOP has yet to pass a repeal or a replacement for Obamacare, and certainly not for lack of trying. Why is that? Why has the GOP not been able to do something that literally every single member of their caucus and the vast majority of their constituency agrees needs to be done? Now that they have complete control of the law making process, why are they not able to pass this legislation?
Stubborn Obamacare
The answer is simple, and yet painful for the Right. Obamacare did make things better. For all of the screaming about a repeal, and all of the hyperbolic language about how Obamacare was Socialism and Totalitarianism, the fact is that Obamacare did improve the healthcare landscape for most Americans.
Now Obamacare obviously has a lot of problems that are worth criticizing, that is true, but it is simply impossible to deny that Obamacare got more citizens covered and provided a slew of new protections and assurances to curtail some of the most painful and reviled of insurance practices. For all of the faults with Obamacare, it is still better than things were before, and that is easy for many people to forget, right up until they are faced with the reality of things reverting to how they once were.
When faced with the return of lifetime caps, rejection due to preexisting conditions, children being removed from their Parent’s coverage at age 18, and the other former statuses quo, people suddenly realize how vital the improvements and protections Obamacare did create really are. As it turns out, even the most conservative of states and counties in the country, when faced with the repeal of those protections, will turn out en masse to tell their Representative and Senator, in no uncertain terms, “Don’t you dare.”
Replacement Pains
So an outright repeal is off the table due to the all-but-certain electoral blowback it would cause. But what about a replacement?
This carries with it a whole other slew of challenges. As it turns out, healthcare, and what to do about it’s rising costs, is an incredibly complicated and difficult problem to answer, particularly if you are the party of small government, free markets, and deregulation. There simply are not very many viable ways to incentivize a market to lower its costs and become less profitable. This is especially true when the product the industry offers is life itself, a service that can hardly be refused, limiting the effectiveness of free market pressures would normally apply to virtually any other product. As the GOP is discovering, there are very few models that can preserve a relatively unregulated healthcare and insurance market, while also providing additional protections for consumers and attempting to lower costs. Obamacare was one such model, perhaps the only such model we've come up with in this country.
It is important to remember that Obamacare was modeled very closely off of Romneycare, a plan concocted by a Republican Governor and implemented by a Republican State Legislature. It is a plan that, at the time, was lauded by fellow Republicans as striking a great balance between free markets and government oversight. Romneycare, modified into Obamacare, was already the centrist moderate position that tried to balance these two ideological concerns.
But Conservatives have spent 6 years trying to convince that nation that what already was a moderate centrist middle ground was actually a radical leftist position. And now they are being confronted with the consequences of that campaign. After having spent so long convincing the public that something like Obamacare in an insufferable level of Government control, painting the middle as actually being far left, they have skewed the entire scale, leaving themselves with even less Government control and only far right solutions that they can use while maintaining ideological integrity.
And that task is proving to be nearly impossible.
The Lesser of Three Evils
And so the GOP is left with only three real paths forward:
First, they do nothing, leaving Obamacare in place, and appear as liars and cowards who spent years making political hay over repealing Obamacare, and then when holding all of the cards to do so, folded and refused to act.
Second, they pass something that is essentially Obamacare in all but name, using a similar level of Government intervention, and similar regulatory devices to achieve similar results, making them look like hypocrites who spent years criticizing Obamacare just to make partisan noise but who ultimately do more or less the same thing when put in charge.
Thirdly, they do repeal and replace Obamacare with a more free market based and Conservative plan that strips many of the protections afforded under Obamacare, causing wide-spread loss of insurance coverage and a return to the bad ole days of preexisting conditions and lifetime caps.
The problem is that all three of those options are political suicide. All three of those options leave a frothing sea of angry voters, and with full control of Congress and the White House, there will be utterly no doubt in voter’s minds exactly which party did it to them. That is a dangerous proposition coming up on a mid-term election in which backlash over Trump is all but assured anyway.
They have painted themselves into a corner, and it is almost impossible to see a way out.
Conclusions and Assumptions
So what do I think will happen? What I believe will happen is that the GOP will repeal and replace Obamacare with something that is essentially the same as Obamacare but with just enough minor differences that they can claim it not to be. There will also likely be a largely symbolic contrition to the Free Market in the bill, something that has virtually no actual real world effect, but allows them to make a talking point out of having restored free market values.
And for the record, just to make this very clear, it is possible that the GOP may actually craft a superior Healthcare bill that simultaneously lowers costs, increases coverage, maintains or expands consumer protections, and does so through minimal government intervention and Free Market mechanisms. Despite my ideology, ultimately I am most interested in results, and would support such legislation if it was written.
It is possible such a bill may be drafted by the GOP, I just find it unlikely in the highest possible degree that such a thing will happen.
Have you heard of or perhaps personally devised a healthcare model by which costs could be lowered, coverage increased, with little to know loss of enrollment, while also using minimal government involvement or regulation? Is such a thing even possible? Sound off in the comments and let me know. If you'd like to see more discussion on such topics, please follow me.
Yes I've devised a plan, or rather the idea of a plan. It's called V.O.I.C.E. The Vice Operational Integrity and Counter Exploitation Act. It would end the war on drugs, legalize drugs, prostitution and gambling, things we can't stop people from doing anyway, and tax them to support things we need like health care, rehab, education and anti-human trafficking.