GOP health care fantasies

Rep. Charles Boustany was in an unenviable position when he had to give the Republican rebuttal to President Obama’s health care address.
Opposition responses are always dull and do few favors for the politicians giving them.
Speaking for just a few minutes in a bland, dark room, the Louisiana Republican was tasked with laying out the Republican alternative to the Democratic health care proposals Obama had just gone on prime-time TV to promote.
His speech raised more questions about Republican plans than it answered.
Obama has tried to frame the debate on health care as though only greedy lobbyists and other special interests could genuinely oppose his health care plans.
He exaggerates. A critical look reveals plenty of flaws in the Democratic health care bills introduced so far.
But is GOP opposition based on concern about these flaws or cynical politics?
Republicans have introduced health care bills and pushed plenty of their own proposals. But many of these proposals are incomplete, and some are actually quite similar to Democratic plans.
Most importantly, none of the Republican plans are any clearer about funding than the Democratic bills most Republican congressmen are trashing.
In his rebuttal, Boustany referred to Democratic proposals as “government-run health care.” Yet the plan he outlined involved letting people purchase health care across state lines and forcing insurance companies to take on those with pre-existing conditions.
Such a shift to regulating health insurance at the federal level sounds much like the Democratic plans for a national health insurance exchange.
Boustany also said Republicans wanted to provide assistance to those who still cannot access a doctor.
The House Republican Health Care Solutions Group recommended extending the tax savings for employer-provided coverage to those who purchase insurance on their own. The group also suggested providing new tax credits to low- and modest-income Americans.
Expanding the de facto tax credit for employer-provided coverage to those who purchase their own insurance would fix a major distortion in the health care market that hides the true price of coverage from consumers. And new tax credits are necessary to help the poorest insured get more coverage.
But providing new tax credits and expanding old ones is expensive. Republicans suggest they could pay for their plans with medical liability reform, usually just referred to as tort reform.
This would save money, but hardly enough.
One bill introduced by Republicans, the cheery-sounding Empowering Patients First Act, has plenty of good proposals, including the expanded tax credits. The bill would also provide federal grants to help states establish risk pools that make covering those with preexisting conditions feasible.
Unfortunately, the bill claims most of its funding would come from fighting waste and fraud in Medicaid and Medicare. The rest would come from tort reform with, the bill’s Republican authors claim, no need for a tax increase.
Republicans and Democrats alike seem to think they can reform and expand health care without any sacrifice using bills that pay for themselves.