The Republican Health Care Failure

Why the GOP should save a share of blame for itself


Republicans fault President Obama for plans that would greatly expand federal outlays on health care, enlarge the federal role in the provision of medicine, doom private insurance, and wrestle Aunt Sally into the grave. They have some valid points. But while they're heaping blame on Obama, they need to save a share for someone else: themselves.

His GOP critics in Congress, after all, have proposals to help the uninsured and curb health care costs. During his speech to Congress Wednesday, they waved their own bill at him. But for four years under President Bush, we had not only a Republican president but also a Republican Congress.

And what happened? Nothing. Republicans left health care reform to wait until the Democrats regained power, and now the Democrats have.

One reason the president has a good chance of getting ambitious legislation passed this year is that so many health care failures have gone unaddressed for so long. Obama and his allies can justify their program partly because the GOP has been so slow and tepid in offering alternatives. If the choice is between the quite imperfect Democratic plan and nothing, the public may prefer the Democratic plan.

It didn't have to be this way. Republicans actually have some plausible ideas for improving the health care system. Let small businesses band together to buy insurance? Sure. Medical malpractice reform? Bound to help. Giving federal subsidies to help low-income individuals buy coverage? Go for it.

But for Republicans to propose all these measures brings to mind my friend who, new to Chicago, approached a city transit officer and said he'd like to get to State and Randolph streets. The frosty reply: "Buddy, who's stopping you?" The only people who stopped Republicans from putting these ideas into practice were Republicans.

Former Reagan administration official Joseph Antos, a health care expert at the conservative American Enterprise Institute in Washington, is among those who wonder why. "The sad thing is Republicans have been talking about these things for a long, long time," he told me.

You may have forgotten that George W. Bush made a big deal of proposing tax credits of $7,500 per person or $15,000 per family to purchase medical coverage. He did that in 2007, only to be spurned by a Democratic Congress. Why did he wait till the seventh year of his term? He didn't. He had offered the idea in 2004, only to encounter raging indifference in his Republican Congress.

The truth is Republicans just can't muster an interest in the subject until a Democratic president comes along and offers legislation, which is their cue to wake up and scream in horror. They solemnly agree the existing system has a host of serious flaws. But they can never get excited about fixing them—only about making sure Democrats don't get to.

"The passion you need to drive health care reform through Congress has not been present with Republicans," laments Gail Wilensky, who headed the agency that runs Medicare under President George H.W. Bush and advised both George W. Bush and John McCain. "Even liability reform—they couldn't get that through."

Stuart Butler, a veteran health care expert at the conservative Heritage Foundation in Washington, shares her frustration. When I asked him whether he blamed Republicans for not adopting sensible innovations when they held power, he replied, "Absolutely! They just don't get it. They just feel that it's not something they do, somehow. Republicans missed a tremendous opportunity."

Actually, they did worse than miss an opportunity. They stimulated the public appetite for lavish federal spending on health care while catering to the illusion that it can be provided painlessly.

"They put in prescription drug coverage for Medicare," Butler complains, "the biggest entitlement since the Johnson administration." That program is projected to cost nearly $1 trillion in federal outlays over the next decade, most of which will be paid for by sending the bill to our children.

So now we have the GOP railing against Obama because he rejects their good ideas, busts the budget and enlarges the government's role in our lives. No wonder they're mad. Heck, if that's what the American people wanted, they could have left Republicans in power.


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  1. please turn off the steve chapman

  2. The majority of Americans do want healthcare reform. They're just not crazy about the Democrat's Plan. And you're probably right, that the Republicans blew a chance for a political victory.

    In Taiwan, it was conservatives that enacted the nation healthcare plan, not liberals. I fully expect the Democrats to pass some sort of plan. I also expect Republicans to "clean it up" in 4 or 5 years or so. And maybe, in about 10 years, we'll have something that actually works. But I'm not holding my breath.

  3. Thank you very much. I am wonderring if I can share your article in the bookmarks of society,Then more friends can talk about this problem.

  4. Once this article is in the Bookmarks of Society, no one will be able to stop us! Huzzah!

  5. Who ever suggested the Republicans were not to blame? That is not the point at issue. The point is that the Democrats are trying to ram something through that will make the patient's condition ten times worse.

  6. Not quite fair, Steve. It was all the Republicans could do to keep the drug bill in the private sector. The press wasn't going to let any of those other good ideas get anywhere then, just as it is now.

  7. The majority of Americans do want healthcare reform.

    If by that, you mean that a majority of Americans want to change the way healthcare is paid for, I'd agree. Some want a Canadian-style Single Payer system, some a mixed Continental Europe or Australian style one.

    But zeroing in on a "majority" that agrees on one way to do this is a tougher proposition. And this wide diversity of opinion and wants is precisely why the kind of single sweeping solution that so many want is out of reach. America is simply to big. No other country in the world the size of the USA has a national, universal healthcare financing system that delivers services in any way that most Americans will find satisfactory.

    The fact is that a significant number of people who have a problem with "healthcare" just want someone to pay their medical bills.

  8. Let small businesses band together to buy insurance? Sure.

    Actually, I'm not listening to any "healthcare" reform proposals that don't propose ending the tie between employment and insurance and creating an national market in health insurance.

    These changes would promote portability. When we have portability maybe we can start talking universality.

    Absolutely none of the changes I see in the current proposed bills will do anything at all to deliver "reform".

  9. The Republicans are all for small-government when they're not running it. Politically, it serves them better than the Dems, which is vote for everything that crosses your desk.

    I think half the reason Dem leadership speaks of "bipartisanship" for health-reform bills - whether they themselves realize it - is a need for accomplices when they pass the crime.

    It really worked for the Republicans. The Iraq war was a "Republican fault" in the context of the Bush administration concocting and starting it. However the Democrats anxiously jumped on board that turkey, every Dem Senator that was in the Senate in 2003 and ran for President since voted for it. That vote seriously scuttled any valid Dem criticism of the Prez until an Illinois State Legislator showed up.

    That same philosophy applies to every mess Shrub got away with: Patriot Act, warrantless wiretapping, Gitmo, Medicare expansion, TARP, SarbOx. As a matter of fact, the Democrats were the most dysfunctional, co-opted "loyal opposition" I'm aware of in the history of Congress during the Bush years. Outside of culture-war shit (nominees to the Supremes, District Attorney firings, etc.) the Democrats helped, not hindered, the President's agenda.

    Politically, its hard to blame the other guy for the murder when you're helping twist the knife. The Democrats need Republicans to get some blood on their hands with the climate-carbon-taxing, health "reforming," union-humping Obamagenda. After forcing these turkeys down everyone's throats they'll need some bipartisan "cover" come election time and they know this whether they admit it or not.

    The Republicans are an effective opposition when they're out of power though (at this point, thank God for that I might add), unlike the Democrats who under Pelosi and Reid are a clusterfuck no matter how their political head-count adds up. I mean Trent Lott, Tom DeLay, etc. were goons, but they were effective goons. Watching these two Dems run their respective caucuses is just the Amateur Hour in Power. Really bad.

  10. they may not have done anything with healthcare, but they tried to get social security fixed, and they got killed for it. not sure you can blame them for declining to tackle an even more complex issue.

  11. not sure you can blame them for declining to tackle an even more complex issue

    Since that's their only job, I think I can blame them plenty.

  12. First, the Republicans never had a filabuster proof majority in the Senate. So, how exactly were these "sensible reforms" going to get passed over Dem objections? Magic I guess. Second, even if they Republicans had managed to get them passed, is Chapman really so stupid as to believe that Obama would have concluded that there was no need for Obamacare? I think not.

  13. Remember all the recent hysteria about Sarah Palin and the "death panels"?

    Well, there's a new article in Newsweek magazine by Evan Thomas. The title of said article? "The Case for Killing Granny". If you don't believe me, go ahead and Google it; you'll find it in no time.

  14. The only people who stopped Republicans from putting these ideas into practice were Republicans.

    Umm, no. The Republicans never had as large a majority as the Democrats do now; are the Democrats the only people stopping themselves from putting their ideas into practice?

    Furthermore, extending the income deduction to individually bought insurance in particular was passed as an amendment to about half a dozen bills in the last twelve or so years. I remember reading about roll calls about it when Clinton was President. Of course, every bill containing that measure was filibustered and/or vetoed by Clinton. In addition, since that counts as a tax cut, it's subject to the Byrd Rule (adds to the deficit) and can be easily removed from any bill unless there's a 60 vote majority to waive the rule.

    Though at the same time, the Republicans never made an enormous issue of it, and could have. Perhaps you think that they wasted their time and energy attempting to pass something on Social Security and getting blocked by a combination of Democrats and Democrats rallying public opinion? (More likely you have many other things that you think were wastes of time.)

  15. If the Republicans had put up a health care plan the Dems would have just added to it until we had universal health care a la Europe or the UK. What you need to understand is that the thrust is not to provide health care but to gain power over people's lives and the manner in which they live their lives. Slavery in short.

  16. Sorry, but no. I used to be a full blown liberal and believe me, single payor is a religious issue for them and, in fact, if the Republicans moved the ball a bit closer, the Dems would have probably remarked that it was time to take it a step further. Also, the Dems would not have allowed a Republican plan. They would have booed President Bush in full session again if he proposed some changes, demoninzing him as usual. (Funny how no one was upset by their group's enmasse boorish behavior but are upset with Joe Wilson.)

  17. Does Mr. Chapman seriously think that the fact that Republicans failed to put health care reform through on their watch was their fault?

    Last time I checked, the Democrats in the 1994 - 2006 period were adamantly opposed to each and every health care proposal the Pubs put forward, and let the drug bill through only because it was such a sugar cookie that even they couldn't resist.

    Suppose the Pubs had put forward a plan in that time that called for more HSAs, insurance pooling, elimination of pre-existing illness clauses, tax reform to help individuals buy insurance and help so that the poor could buy insurance.

    Oh wait, they did put such plans forward. A couple of times.

    Each time, the Democrats ensured that such proposals were buried.

    The Democrats were not about to let the Republicans get any credit for "health-care reform", just as they weren't about to let the Republicans get any credit for social security reform. Those are Democratic touchstones, Mr. Chapman, and they aren't about to share credit.

    Now one could argue that President Bush, in the 2002 - 2006 time frame when he had a Republican majority in each house, could have pushed harder. Then again Mr. Bush, like all politicians, knew how to count, and he knew he would never get to 60 in the Senate.

    Mr. Chapman is simply adding to the 'bury the Republicans' meme that the MSM has had out there for a while. This article was also in the morning Chicago Tribune, and it's more evidence that the Trib isn't the Colonel's paper any more.

  18. Not to mention some of the "Republican" senators included big government lovers like Snowe, Collins, Chaffee, and Spector.

  19. The GOP was going to get tort reform through with their razor-thin majority? Right. Ditto for competition across state lines. They couldn't even get Fannie Mae and Freddie Mac regulated, despite the Dems getting the payola and the GOP getting the blame when it all went South. The Dems own this issue, and are running it the same way they ran Fannie and Freddie (i.e., milking the issue for cash and votes, and running it into the ground). Blaming skyrocketing health care costs on the GOP is more than a little rich.

  20. As a 54 year old small business owner who has been a registered Republican since the age of 18, I submit the following:

    - the most striking thing about the GOP over the past 10 years has been its lack of leadership.

    - second, is the consistently high level of hypocrisy among Republican leaders. Our party appears to be controled by individuals who espouse values that they lack the character to uphold.

    - limited government, what a joke. The GOP reminds me of an individual at a county fair who places second in pie eating contest only to claim that he would have finished first if the winner had not been a glutton.

    - family values? I really wonder is there is a Republican "family values" office holder that is not running around on his/her spouse.

    Yes, we blew it on health care, on TARP, on set-asides, and a host of other issues. Don't confuse opposition to the Democrat agenda as support for the GOP. It is not.

  21. More importantly, the Republicans did repeatedly pass bills to strengthen and encourage Health Savings Accounts and Consumer Driven Health Care plans. You know, the types of plans that Peter Suderman has praised, that John Mackey praised in his WSJ op-ed, that the overwhelming scientific evidence so far supports?

    It's simply untrue to say that the Republican Congress did nothing on health care. HSAs and consumer driven health care plans are important.

    I don't think that that dampened Democratic enthusiasm for government health care. Every single one of John Mackey's ideas could be adopted, and the Democratic Presidential candidates would still be proposed health care changes.

  22. Republican Health Care reform? How did that Social Security Reform go for the Republicans?

    Unless it involves a more intrusive Federal Gov't the Dems are against it.

  23. I'm not convinced of the argument. The republicans tried to do the hard part, fix medicare/medicaid before trying to "fix" the rest of healthcare.

    If the dems would fix those two, they'd get much,much more support for their next plan.

    As it is, the entire thing is going to be just another government give-away, with our children paying the bills..

  24. Well I wouldn't call the expansion of precription drug coverage the largest expansion of medical coverage since Medicare "nothing".

    You forget, when Republicans are out of power, they believe in the free market and competition, when in power they believe in stopping competition against campaign donors, and state solutions don't look so bad.

  25. A very ignorant opinion piece. It is too bad that Reason didn't actually read it before approving it.

  26. The Republicans are far worse than you say. Not only did they refrain from reforming health care in a positive (free-market) way, they voted in the largest increase in government medicine since the 60s (the Medicare drug bill).

    Check out this article by John Lewis which elaborates on the perpetual failure of Republicans to offer a principled opposition to the Democrats' statism: http://www.theobjectivestandard.com/issues/2009-fall/obamas-atomic-bomb.asp

  27. HSA's ect weren't real reform. The Republicans avoided all of the tough issues. Like keeping overall costs down.

    And there fixes for SS, didn't amount ot much either.

    So the can keeps getting kicked down the road, as our nation moves closer to involvency.

    Of course Obama's plans don't help matters. But that's because they are avoiding the tough issues too. Cost contaiment, and making people responsible for their own lifestyle choices.

  28. Bertram:

    "Actually, I'm not listening to any "healthcare" reform proposals that don't propose ending the tie between employment and insurance and creating an national market in health insurance."

    I'm with you. The only part that gives me pause is the potential regulatory complications of administrating health insurance across the states. Ending the relationship of health insurance to employment - absolutely. It is a relationship bred of convenience and it's created big problems. We need to get rid of it.

  29. Valhalla

    I am naturally uneasy about any change in a regulatory regime. But I definitely believe that national insurance markets would be a big improvement.

    And in the case of health insurance i believe they would certainly enhance portability. And of all the buzzwords being buzzed, portability is the one I unequivocally believe to be good.

    But frankly I don't see portability being enhanced here.

  30. What 0bama and his band of social engineers is proposing merely ices the rotten cake Kennedy and Johnson cooked up in 1964. Government run health care does not work. No more than government run housing, education or any other of the facets of normal life the Constitution prohibits the federal government from intruding. We have reached a point where we must insist on taking control of OUR lives and our responsibility as individuals. We must rely on one another and not on a government which promises to help us, for a price.

  31. I fully expect the Democrats to pass some sort of plan. I also expect Republicans to "clean it up" in 4 or 5 years or so.

    If by "clean up" you mean keep adding on extra spending onto, then you're right on track. If that's not what you mean, then why do you expect this to be different than every other entitlement program ever?

  32. First, the Republicans never had a filabuster proof majority in the Senate. So, how exactly were these "sensible reforms" going to get passed over Dem objections? Magic I guess. Second, even if they Republicans had managed to get them passed, is Chapman really so stupid as to believe that Obama would have concluded that there was no need for Obamacare? I think not.

    I think that you miss the point - if Republicans had made a sustained effort to bring these bills on the floor and go through the various committees, they can atleast SHOW that they TRIED to bring reform.

    I have been thinking about this myself - what EXACTLY has the GOP done in the 15 years since it defeated HillaryCare ? Nothing... nothing really of any substance or real consequence - HSA's are not a panacea by any stretch of imagination.

    When the Social Security crisis deepens, the GOP can rightly point out that it alteast TRIED to enact some modest reforms. Of course, the plan did not have any support from the GOP itself and Democrats would rather die than have the coercive individual manadates removed.

    But, Republicans can fairly claim that they tried to come up with common sense reform ideas and the Dems where totally united in their opposition without offering any reasonable alternatives (other than increasing the payroll taxes, the Dems have NO IDEAS WHATSOEVER - but thats not surprrising)

    This leads to the NEXT obvious question - Why ?? Why was the GOP totally useless when it came to addressing health care reform ?

    Is it possible that top leadership in the GOP was in the pocket of the insurance industry ? After the Medicare Part D nonsense, you would be hardpressed to deny that.

    Of course, the Democrats are also siding with the special interests - those who usually support the GOP are with the Dems now. Why ?

    They tried to stop reform as long as it was possible-and once they realized that their game is up, they are now lining behind the Dems to get the best deal possible.

    I cannot imagine a health care company openly asking for individuals to drop their employer plans and purchase insurance directly - why the hell would they ? They were getting more profits by going through the employer !

    US Health care system is chock full of perverse incentives.

    Dont be surprised if the public supports the public "option" or worse single payer in the next 10 years.

    The fundamental weaknesses of the current quasi private insurance system still remains.

  33. Where's Tony and Chicago Tom? They always cry that Reason does nothing but protect Republicans, but when an article like this is written, they're no where to be found.

  34. I would suggest that the reason that the Republicans did not introduce legislation in this area is that all of the free market ideas that are clearly needed are easy to demagogue and would make for great 30-second scare political ads.....Now that the alternatives are being presented by the Democrats, these ideas can be more appropriately explored and debated.

  35. Again we watch as the redirect goes to work. NO health care plan is any good that keeps the cost where it is. Discuss how to cut cost not who should pay for it. We get nothing until the cost is under control. IF that means "Nationalized" or "Socialized" or even "Free" it will not exist until it cost less.

  36. Breaking in your new running shoes will take some time so you might want to consider buying new shoes before your old ones fall apart. Nothing is worse that not having your old running shoes to fall back on while you break in the new ones.

  37. My only point is that if you take the Bible straight, as I'm sure many of Reasons readers do, you will see a lot of the Old Testament stuff as absolutely insane. Even some cursory knowledge of Hebrew and doing some mathematics and logic will tell you that you really won't get the full deal by just doing regular skill english reading for those books. In other words, there's more to the books of the Bible than most will ever grasp. I'm not concerned that Mr. Crumb will go to hell or anything crazy like that! It's just that he, like many types of religionists, seems to take it literally, take it straight...the Bible's books were not written by straight laced divinity students in 3 piece suits who white wash religious beliefs as if God made them with clothes on...the Bible's books were written by people with very different mindsets.

  38. Nothing is a failure if people unite for one purpose. The welfare of the majority is of most importance above any other issue.

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