Judging from the comments, there seems to be widespread misunderstanding of my post yesterday about what Republicans could have done differently in the run-up to Obamacare. I reject completely the idea that negotiating with the Democrats in 2009-10 would have produced any meaningfully conservative results. I am not advocating any “Obamacare lite” or slower adoption of government-run health care.
The exact opposite: Republicans should have championed policies that move health care in a more free-market direction, with fewers mandates and regulations, with more freedom for consumers to choose. They should have removed the distortions in the tax code that make it difficult for people to obtain health insurance apart from their employer.
It was actually Republican indifference to free-market health care reform that produced Obamacare Lite as well as Obamacare. When we hear about the conservative/Republican pedigree of the individual mandate, that history is almost entirely a product of conservatives looking around for some alternative to Hillarycare’s employer mandate, grabbing something that was supported by a handful of wonks, and then hoping the issue would go away. But the fact is that public discontent with rising health care costs, which endanger political support for limited government more generally by eating away at wage growth, didn’t go away. Neither did some level of concern about the uninsured.
The final outcome was that the country ended up with Obamacare. Our best hope for Obamacare’s repeal is the election of a former governor who is perhaps the only Republican in the country to try to seriously promote Obamacare Lite at the state level, helping to further implicate the GOP in the history of the individual mandate.
I think, and have written repeatedly, that Republicans were right to throw themselves in the tracks two years ago and hope they could stop the oncoming Obamacare train. But if they had dealt with health care on free-market terms when they ran the government, they might have been able to derail it before it left the station.