Here’s something quite striking about the Republican alternative to Obamacare:
A preliminary (non-C.B.O.) score shows that it insures slightly more people than Obamacare and reduces the deficit, relative to current law, by $1.4 trillion over the next ten years… How does it accomplish this feat, you ask? Well — it pushes people buying on the individual market toward cheaper insurance plans with much narrower physician networks, and it reduces the tax subsidy for employer-provided insurance more substantially than Obamacare’s Cadillac tax would do.
Which is why I think such alternatives can and should be explored (and might even have had a chance of making it into the bill if the GOP hadn’t had a psychic meltdown almost as soon as Obama took office). But, of course, this means that many more people may have to switch doctors under Obamacare Lite than under Obamacare Classic. It also means that businesses will be hit hard with more taxes once their cushy subsidy, unavailable to those in the individual market, expires. Now I’m quite sympathetic to both ideas. If we’re going to cut costs, something like the former is vital; if we’re going to create a more viable individual market, then corporate taxes will have to go up. But haven’t Republicans been trashing Obamacare on precisely those grounds – that you have less choice over your doctor and that there’s a hidden tax increase in all of this?
Donald H Taylor has a must-read on all this. Money quote:
Narrow network plans don’t bother me one bit (I thought everyone wanted to reduce costs!), but the ad machine that is trying to give the Republicans the Senate in 2014 is demagoguing something that is a feature and not a bug of the plan put forth by Republican Sens. Burr, Coburn, Hatch.
Indeed. Because the GOP has not been a conservative party these past five years, but a raging, irrational id, it has opposed Obamacare on any grounds, including liberal ones. They hate it because it may restrict some patient choice, but they hate it because it allegedly spends too much money. My advice: pick one. And the one to pick is the maximal extended coverage with the maximal cost controls. Burr-Coburn-Hatch tries to do this – and may fall between two stools, merely proving Obama right. But the Republicans cannot run on repealing Obamacare when they are effectively proposing to fine-tune it. And they cannot run both on maximal patient choice and lower costs.
They have to choose. Finally, as with immigration, they are being forced to admit that their most practical vision is not that far apart from what Obama has already enacted or proposed. Their bluff is finally being called as they have to present themselves as an alternative governing party and not just a cable entertainment company.
Yes, I’ll go there. Meep meep.