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On Healthcare, GOP Should Think Long-Term

Walter Russell Mead

The GOP congressional caucus is in chaos as it tries to ram through the Obamacare repeal it has been promising for seven years but never really thought through. The Washington Post reports:

The Republican health-care overhaul faces its greatest test ever Thursday as President Trump and House Speaker Paul D. Ryan (R-Wis.) work feverishly to persuade enough Republican lawmakers to back the measure and push it to a floor vote.

Late Wednesday, the White House and House leaders were still scrambling to boost support, and signaled at the 11th hour a willingness to rework the measure to mollify conservatives. On Thursday morning, House leaders postponed a 9 a.m. meeting of the entire GOP Conference, signaling that negotiations were still underway.

The Republicans have fallen into a trap. The problem with American healthcare isn’t the way it is paid for, at least not in the short term. The problem is that our bloated system is too inefficient so that it costs too much no matter how we pay for it.

Thus, healthcare policy has to involve two things: A short-term system to help people navigate the current disaster, and a plan to make the system sustainable over time. Obamacare “repeal” should be about temporary reform of the worst features of the law—especially regulations that are unnecessarily cementing bad things into the system.

The long-term cost problem wasn’t created by Obamacare, and it won’t be undone in a single piece of improvised legislation keeps the law’s structure but makes the taxes and transfers less progressive. As we’ve noted before, the healthcare Gordian knot reflects, among other things, “the cost of delivering universal health care to a population with many different expectations, wants and needs … the toxic mix of bad policy and perverse regulation that goes back well before Obamacare … the problematic nature of linking health insurance to employment in a rapidly changing labor market … the failure to capitalize on the immense potential of technology to deliver better health care in innovative ways.”

Addressing these deep-rooted problems will take a much greater level of imagination than we have seen from the House GOP as of late. In any case, it’s better to take healthcare slow than to take it fast. Every administration and congressional majority that made this its top priority has wasted huge opportunities and suffered political losses.

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