Ezra Klein: GOP’s ‘Horrifically Unpopular’ Health-Care Ideas Will Eventually Result in a Single-Payer System

In the long run, Republicans’ health-care-reform efforts are going to backfire, suggested Vox editor-in-chief Ezra Klein last Thursday. Klein argued that if Congress junks the Affordable Care Act, “Medicare for all” will become a rallying cry for Democrats, and once Dems return to power, “they’ll pass what many of them wanted to pass” instead of the ACA: “A heavily subsidized buy-in program for Medicare or Medicaid, funded by a tax increase on the rich. A policy like that…will satisfy an angry party seeking the fastest, most defensible path to restoring [Obamacare’s] coverage gains.”

Klein observed that

Democrats have long been divided between two camps on health reform. There are the incrementalists who think…that Democrats need to build on the existing health care system and work with private insurers. And then there are the transformationalists, who think Democrats need to push the United States toward something approximating a single-payer system as closely as possible…

Obamacare was the test of the incrementalist theory, and, politically, at least, it’s failed. Democrats built a law to appeal to moderate Republicans that incorporated key ideas from Mitt Romney’s Massachusetts reforms, and it nevertheless became the single most polarizing initiative of Obama’s presidency…The complex public-private design of the Affordable Care Act left the system dependent on the business decisions of private insurers and left Democrats trying to explain away premium increases they don’t control…

Obamacare’s defenders argue that the law has worked well in most states and could be easily improved and fortified. They’re right. The core flaw of Obamacare is the subsidies are too low and the individual mandate is too weak. More subsidies, and some tweaks to the insurance regulations, would do the system a lot of good.

Republicans, of course, aren’t interested in upgrading Obamacare. In fact, as Klein sees it, they’re interested in health-care reform only as a means to a non-health-care-related end:

The true bottom line of GOP health policy [is that] money currently being spent to buy insurance for the poor should be redirected to tax cuts for the rich…

…This is a horrifically unpopular health policy…

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Republicans control the House, the Senate, and the presidency. No one can stop them from passing a bad health care bill if they want to. But they should think carefully about what is likely to come next. Tens of millions of people losing insurance, and they’re to blame. A radicalized Democratic Party with a discredited moderate wing. The end of the assumption that a hybrid public-private model will fare better in America than a government-run system…

Mitch McConnell may prove the best friend “Medicare for all” ever had.

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