There was a time, about thirty years ago, when I worked as a freelance writer. The work was plentiful, but the peripherals were lousy–especially when it came to health insurance. I had to buy it on my own and it was expensive. That’s one of the reasons I was so enthused when Stuart Butler of the Heritage Foundation developed his individual mandate plan for universal health insurance and it featured exchanges–that is, health insurance superstores–where freelancers, self-employed businesspeople and others without a health care plan could combine together and have the market power of, say, Time-Warner or General Motors to make deals with insurers.
It was a classic Republican idea. It employed market discipline to control prices. And it is yet another indication of how far off the deep end the GOP has gone that Republicans are now opposing its implementation in Minnesota and other states.
Why, you might well ask? Because President Obama supports exchanges. It’s an integral part of Obamacare, which was based–remember?–on the Heritage Foundation plan (with some important differences–Obama dumps most low-income people into Medicaid rather than into the exchanges, and he doesn’t make employer-based health benefits taxable on a progressive scale, as Butler did.)
The Republicans argue that the products offered in these health insurance superstores will only be the products approved by liberal bureaucrats. This is nonsense. If the Republicans had deigned to negotiate, if they had fought for a more Republican version of this Republican idea, I’m sure they could have added in all sorts of products, including health-savings accounts. They still could. But then, if Republicans had deigned to negotiate, they could have won their beloved–and commendable–malpractice reform. Obama has said publicly he would be willing to include it, if Republicans stopped trying to kill his Republican plan.
This is a case of extremism and cynicism. The cynicism dates back to Bill Kristol’s 1993 memo to Republicans in the Senate, advising them to oppose any sort of health care plan because Bill Clinton would get the political credit. Kristol, a noted patriot, thus helped create the rot and gridlock that has paralyzed this country for the past 20 years: Democrats could play that game, too–and they did on Social Security reform, where they might have made a few concessions, like raising the retirement age for upper-income recipients and raising the tax cap on upper income workers, while denying George W. Bush his privatization scheme.
But the nihilist tacticians have combined with ill-informed ideologues to create a Republican party that stands in steadfast opposition to Republican ideas. One wonders when some actual conservatives, as opposed to the right-wing radicals who dominate the discourse, will stand up and call out these fools.