Greg Sargent says president Obama has won the debate over Obamacare because the Republicans admit that by repealing it they would have to replace it; and in replacing it address the same issues Obamacare does.
But it may also be that Republicans are running into the same old problem: There just isn’t any real policy space for an alternative that would meaningfully accomplish what the law accomplishes. Indeed, along these lines, one GOP aide was remarkably candid in an interview with Sahil Kapur:
One congressional GOP health aide, who was granted anonymity to speak candidly, said his party is as determined as ever to fight Obamacare, and will remain so as long as it exhibits failure. He said devising an alternative is fraught with the difficulty of crafting a new benefits structure that doesn’t look like the Affordable Care Act.
“If you want to say the further and further this gets down the road, the harder and harder it gets to repeal, that’s absolutely true,” the aide said. “As far as repeal and replace goes, the problem with replace is that if you really want people to have these new benefits, it looks a hell of a lot like the Affordable Care Act…To make something like that work, you have to move in the direction of the ACA. You have to have a participating mechanism, you have to have a mechanism to fund it, you have to have a mechanism to fix parts of the market.”
The whole debate is missing three big words. Health. Care. Compact. Sargent is right to say that repealing any big Democratic health program and replacing it with a big Republican Health Care program out of Washington is likely to create another monster with family similarities.
That is precisely the reason why the Health Care Compact remains the most innovative approach to the health care policy problem to date.
The problem for the HCC is to cast itself as a viable alternative to these failed dinosaurs. The key problem the HCC must overcome is the objection that “it’s a good idea but it will never fly”. This has to change to “it’s a good idea and therefore it will fly, because the failed approach of centralized bureaucratic health will never get off the ground.