What Happened To “Replace”?

Among Ross's criticisms of Paul Ryan's budget:

It repeals, but doesn’t replace. Obamacare disappears, in other words, and nothing takes its place.

We know that this isn’t Paul Ryan’s personal preference: He wants to repeal the new health care law and replace it with something like the bill he co-sponsored with Oklahoma’s Tom Coburn, which would convert the tax exclusion for employer provided health into a universal credit. But apparently that’s still a bridge too far for many of his colleagues, which means that this budget would take us back to the unacceptable pre-Obamacare landscape, in which the (ever-growing) number of Americans who don’t get health insurance through their employer are massively disadvantaged in the insurance marketplace. In a budget that imposes plenty of pain already, a return to the status quo ante on health care is a very bad idea.

I agree. What we desperately need is some conservative buy-in on the cost-control experiments in the health insurance reform. And an embrace, not a demonization of asking Medicare patients to plan their end-of-life decisions in advance. What if we managed to reduce end-of-life intensive care by a third? There are some huge savings there, which is why Palin's demagoguery has been so toxic to fiscal conservatism. You cannot be a party in favor of fiscal restraint and yet oppose the very cost-controls that Obamacare has innovated.