Republicans should declare victory on health reform, but they won’t
By Michael J. Pramenko, M.D.
There is no question that my views on health-care reform rank somewhere between a kidney stone and a prostate exam with today’s conservatives. And, the Republican National Committee is surely not going to take any advice from me.
Nevertheless, after more than 8 million Americans have signed up for health care under the Affordable Care Act and millions more covered via Medicaid expansion, here is some salient political advice for Republicans regarding the ongoing debate on health care policy.
That’s right. Declare victory on health reform.
Here’s why. The Republican-designed ideas of an insurance exchange and individual mandate are showing signs of success. Remember, these two policy recommendations came from Republicans during the decades-long debate on how to fix our health-care system and cover more Americans. Republicans, believing that these policy recommendations could keep us from moving toward a single-payer system, once openly favored these elements of reform.
Those very same Republican health policy recommendations, voted into law by a Democratic Congress and President Obama, are working. With millions of Americans now signing up for health care and the number of uninsured steadily declining, the likelihood of a single-payer system fades into the political sunset. At the same time, health insurance companies posted one of their better years in the stock market. The same law that conservatives proclaim as moving us toward a single-payer system is clearly doing the exact opposite.
Don’t stop there. There is more political gold worth mining. Over 70 percent of Americans believe that pre-existing health conditions should not preclude people from being able to buy insurance.
The individual mandate is the mechanism in a privately run insurance marketplace that allows for coverage of pre-existing health conditions. Without the enlarged insurance pool of patients created by the mandate, insurance companies would go out of business if they were forced by law to insure everyone with significant health problems. Remember, before the Affordable Care Act, there was no consumer protection regarding this issue.
What are you waiting for Republicans? Declare victory. You designed a policy recommendation that led to an insurance environment favored by over 70 percent of Americans. Celebrate.
Currently, Republican leaders in Congress are attempting to write replacement legislation for the Affordable Care Act. They are discovering the difficulty of designing a system that isn’t government run but will guarantee coverage for pre-existing health conditions. Watch this closely this year. If alternative legislation is offered and voted on, it likely will only ensure coverage for pre-existing conditions for Americans who already have insurance and not for the uninsured.
So, what are the chances that the old Republican Party can get the new tea party-controlled Republican Party to polish up its political playbook and parlay off practical health care policy?
Furthermore, what are the chances that Republicans will declare victory regarding successful policy recommendations that they designed back in the 1990s?
Probably about the same chance as seeing an elephant fly.
Michael J. Pramenko M.D. is the executive director of Primary Care Partners. He serves on the Club 20 Health Care Reform Committee and is a past president of the Colorado Medical Society.