Everyone expects the new Republican House of Representatives will vote to repeal Obamacare. This move will probably be blocked in the Democrat-controlled Senate, however; and failing that, the president will use his veto pen to save the Democrats’ crown-jewel policy achievement.
Then what? Having health care as an issue may actually be a blessing for the GOP. Obamacare has been a gift to the Republican party. It was the single most important reason for their historic gains in last week’s election. Better still, it’s a gift that can keep on giving, if appropriately managed.
Remember, the really bad features of the law (mandates for individuals, fines for employers, federal regulation of everyone’s insurance, government-run health-insurance exchanges) don’t kick in for several more years (in 2014). In the meantime, Republicans don’t really lose very much if the best argument for voting Republican in the 2012 election remains in place.
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On the other side of the aisle, the health-care-reform bill is an albatross hanging around Democrats’ necks. I doubt if any Democrat wants to cast an up-or-down vote on it again. And as long as it’s there (especially if it’s never really implemented), it will cost the Democrats many congressional seats. Imagine that the start date keeps getting pushed back. Along the way, Obamacare will be a big issue in every election. That scenario would be a nightmare for the Democratic party.
There is precedent for this. Under the Balance Budget Act of 1997, Medicare growth was supposed to be slowed by the gradual ratcheting down of payments made to doctors. Yet, Congress has voted to delay the cuts every year since 2003. Even though the cuts have been delayed for the last seven straight years, each year the Medicare trustees’ report assumes they will be made in all succeeding years. And the issue returns for doctors and for the American Medical Association (AMA) every time we have an election. The so-called “doc fix” is always temporary, never permanent.
Ideally, one hopes the two parties will work together to reform health care in a way that’s good for doctors and patients. If President Obama leaves us all with no choice, however, some have suggested using the House’s control of the budget to deny funding for the program. That may be a good idea, but if it’s all the Republicans do, they risk being seen as obstructionists and labeled “the party of no.” Fortunately, there is much more that can be done.
Republicans should begin by voting to repeal the most politically unpopular features of health-care reform. That means no individual mandates, no individual or employer fines, and no regulations of the type that might cause McDonald’s to drop coverage for 30,000 low-wage employees and the 3M Corporation to drop coverage for all its retirees. If there is a budgetary cost for these measures, pay for them by pushing back what I am going to call O-Day. That’s the day (Jan. 1, 2014) when all the subsidies and mandates are supposed to kick in.
The Democrats will probably be able to block these moves, by either Senate filibuster or presidential veto. If they do, that will frame the issue for voters in 2012.
Then Republicans should come to the rescue of senior citizens. If nothing is done, Medicare will have to reduce its payments to doctors by 25 percent on Jan. 1, 2011. In the succeeding years, reduced payments get really brutal.
According to Medicare’s Office of the Actuary, Medicare payments to doctors and hospitals will fall below Medicaid rates by the end of the decade. Think about what that means. Right now, Medicaid’s low rates make it difficult for low-income families to find any private-practice doctor who will see them. As alternatives, they often turn to community health centers and safety-net hospitals. Now imagine seniors having to do the same thing, but being pushed to the rear of the waiting lines, as even poor people (with their Medicaid cards) pay the doctors more than what Medicare will pay for the elderly.
" issue may actually be a blessing for the GOP. Obamacare has been a gift to the Republican party."
Sure it has been a blessing to republicans but what about my mother? She is a 68 year old cancer survivior. What happens if she gets cancer again? What are the odds that she will be treated for the disease instead of being sent home to die? That is not what we want. I think we HAVE to replael this and start over. I am a very confirmed conservative and I hate this healthcare law. Your idea just throws sand at our opponenets, does not fix anything. It has got to be better that this or we can just throw all of the politicians out and start over. They are not sanctified, they can be fired. I suggest we do so; loudly! Tort reform would put us in a very good position and that may be all we need.
If you think Americans will stand by while their elders at put down to die then you do not know Americans.
This is a great article. Republicans should be wary not to overplay their hand. Singling out the specific warts within the bill individually so voters understand exactly what is wrong with it and don't get tired of hearing about Obamacare being repealed is the right course. Soon, the media will find a poll that shows voters are sick of the issue and want the country to move on. One point you made:
"Do you know if you will be uninsured four years from now? Few people do."
The flip side of that point is that Democrats benefit from much greater numbers of people who fear they will be in position to lose their benefits.
As global warming or any religious belief demonstrates: fear of something that never does happen but always might happen is a powerful tool. Democrats exist because they continually exploit this human tendency.
Republicans are best when they counter fear with optimism and solutions. I hope the incoming new blood keep this squarely in the front of their minds. Obama must pivot to the center but Republicans must also pivot from opposition to solutions.
I registered with NRO just so I could register my shock and incredulity. If you want to lose back the House in 2012, and have another four glorious years of The One, follow the advice in this article. We the People did NOT put the Republican Party back in control so it could continue this sort of cynical realpolitik. We elected you, brand-spanking new Congress, to STOP the health care law, not to use it as a PR tool. How incredibly arrogant, how tone-deaf! The electorate does not want you holding out a repeal of Ombamacare as a carrot on a stick, promising to repeal it...eventually...if we are good little boys and girls and vote for you again. Want to maintain control? Try to repeal. Immediately. Fail, and you can use Democratic obstructionism as a club all you want. But if you don't make a serious effort to follow through on your mandate, the electorate will say, yet again, that "this isn't the change we voted for."
What's wrong with being obstructionist? If the Republicans were obstructionists when idiotic legislation such as Social Security and Medicare came along, we wouldn't have the fiscal nightmare that we are about to face. How about Republicans just act like Republicans and be obstructionist and explain why it is in the American people's interest that they be obstructionist and not say "YES WE CAN!!!" to everything?
The problem with your argument is the Republicans are NOT in control. The Democrats still have the White House and the Senate, and half the population thinks Obamacare is somewhere between an ok and a great idea. The Republicans are going to have to actually win the argument in the eyes of a majority of Americans. In order to do this, they have to:
1) Highlight the things in Obamacare that are most objectionable, and
2) Propose changes that are better than what is in Obamacare. (Obamacare is a bad idea, but health care reform is not).
I think Goodman's ideas advance this approach, and we may indeed have to have a strategy of putting off the worst of Obamacare year after year after year. This is obviously not ideal, but we put these clowns in complete control for two years, and (as the saying goes) it is going to take a long time to clean up the mess they made.
I am guessing the author is not faced with the same situation as the McDonald's and 3M employees are right now: radically bad changes to their coverage, with no balancing improvements in any respect.
The grand strategy proposed by the author may look good from the mountain top, but it's pretty ugly down here on the front lines.
What would Ronald Reagan do? I believe he would fight the fight now, on principled grounds. Stop playing at politics and do the right thing here and now.
As Rush said, "Make them defend it." Make it a major issue, regardless of the Senate's demographics or Obama's veto pen. As last week showed, the voters will side with Republicans in principle. Point out every single flaw (and there are a lot of them) in this bill and use the House to defund those flawed mandates until they're addressed.
Goodman's advice about having a replacement plan is also very important. Republicans need to use this opportunity to offer a viable free-market alternative, rather than simply act as an obstructionist force. The electorate wants Washington to respect their freedom, but they also want a solution.
At 13, I picked a time when my family was temporarily uninsured to nearly die of a ruptured appendix. (My father was a sheet-metal draftsman and his new employer's group insurance required an automatic few weeks activation delay.) It takes a long time to pay off an emergency middle-of-the-night surgeon and over two weeks in the hospital; we managed to pay the doctor finally, but the hospital gave up and took a loss after two or three years. (Fitting, since the heating/ac ductwork had my father's fingerprints all over it.) So I hope that experience establishes my credentials as someone who "knows what it's like" to be uninsured.
Even so, I consider Obamacare to be a Damocles' sword hanging above us all. Despite good intentions and whatever benefit may come to the few, there's a side issue to be considered: people don't go through the purgatory of a medical education just so they can look forward to having their future financial rewards put on an increasingly leaner diet. And as my rheumatologist said to me, we're going to see a lot of doctors in their fifties retiring early. It doesn't do much good to have insurance if there aren't enough doctors to go around.
The amount of money that has gone into tort lawyers' pockets and the amount of money the Democrats have spent battling to keep power so they can force their version of Utopia on America could probably have set up a fat enough fund to group insure a great many poor: that is, if what the John Edwardses of the world and the Democrats were really doing what they think they are doing: fighting a disinterested and noble battle to right an unrightable wrong.
Interesting, but too much risk of Obamacare taking root and metastasizing in unexpected directions. Kill it as soon as politically able. "Repeal it" must be a central GOP platform leading into 2012. Between 2010 and 2012 we'll have had the chance to nail most every politician involved with this awful politician, save a few 2014 senators. And even those might not escape voters' memories.
Dr. Goodman didn't say "don't repeal it." He started out by reporting the good news that the House of Representatives will vote to repeal. We can be 99 percent certain that the Senate will block it. If it passes the Senate, we can be 99.99 percent certain that the President will veto it.
There is nothing that we can do about that until the November 2012 election. It is critical to lay down a "marker" in the House next January. It is equally critical to keep Obamacare on the calendar every month until November 2012, which can only be done - after a House vote to repeal - by putting forward bits and pieces that will get through the Senate and to the President's desk.
To do otherwise would be to lose momentum and political will, without which there will be no repeal legislation for the President who'll be in office in January 2013 to sign.
The author is forgetting something important. The Democrats did not ever intend ObamaCare to be an end state. It is a transitional wrecking ball that will destroy all private health insurance so that single payer/single provider becomes the only politically viable option. And it is working ahead of schedule. It is also very clever. If the Supreme Court strikes down the individual mandate and the few other unconstitutional provisions, the rest of the law remains intact, and its wrecking ball function is rapidly accelerated to warp speed. Private insurance goes into a price-coverage death spiral, especially as private employers drop all coverage and just pay the tax. With divided government, any repeal or change becomes impossible. In fact, most private insurance could be totally gone before the 2012 election. And if this happens, Obama will run for reelection on a single payer/ single provider platform.
