What can one say about the self-serving and purposefully obtuse Mr. Douthat? The fact that Obamacare is the product of The Heritage Foundation? The premier think tank of the, once, most reactionary strata of the Party. The New Democrats took that plan and made it their own. The Republican Party calls it ‘Socialized Medicine’ and other such epithets, yet it is not single payer, but wedded to the welfare of insurance providers and drug manufactures. The Republicans have no real alternative because Obamacare is their own. Except that the No-Nothings are now in charge of the Party, and will brook no compromise with the ever expanding Welfare State, even as the economy is stalled in the grip of a failed and failing Austerity. Mr. Douthat seeks not a real debate, but instead produces a maladroitly constructed side show, that passes for actual political thought. His last two paragraphs are revelatory:
“And therein lies the rub, because you can’t actually have a conservative alternative to Obamacare if you can’t recognize that “managing” the health care system requires changing the way it (already, pre-Obama!) subsidizes health care, which in turn requires increasing the subsidies available to at least some people (the sick, and Americans who don’t get insurance through their employers) even as you reduce them for others (by capping the deduction for health insurance, as a first step). It’s true that this kind of change is a “big government program” relative to the libertarian utopia, but relative to the status quo it’s nothing of the sort, and anyway I don’t see many Republican congressmen casting bold votes to actually eliminate the health-insurance tax exclusion. Instead, they’re happy to just pretend that the existing system represents some sort of free-market ideal in order to score points against the new health care law and avoid taking on any policy risk themselves — and then happy, as in this case, to demagogue as “big government” any constructive steps toward a world that’s actually more consonant with free market principles than the status quo.
This, this, is the Republican Party’s health care problem. It isn’t that conservative ideas about health policy don’t exist, and it isn’t that they won’t work. It’s that right now the feasibility question is purely academic, because even after five years of debating these issues, and despite Eric Cantor’s best efforts, there still aren’t enough Republican lawmakers willing to take even the smallest of steps toward putting those ideas to the test. This means that no matter how much of a “bureaucratic nightmare” the implementation of the current health care law turns out to be, liberals at least have this ace in the hole: When it comes to health care reform, there is still no politically realistic alternative to their approach.”