The Competitive Disadvantage of GOP Healthcare Rhetoric

Despite the shock and awe of Democrats' melodramatic press releases,
nobody was genuinely bewildered or surprised by the recent McClatchy
newspaper headline screaming that "GOP lawmakers tout projects in the
stimulus bill they opposed." We all know that politicians love to brag
about bringing home the bacon - even the bacon they vote against.

Far more baffling are those same politicians contradicting their entire
foundational philosophy. When that starts happening, as it is in the
debate over health care, things can become authentically confusing.

Anyone who remembers the 1993-94 health care fights knows that
Republicans have long asserted that private insurance is more
efficacious and more adored by patients than government-run programs
like Medicare. To solve the health care crisis, those on the right say
we must foster more price-cutting, efficiency-producing competition.
"The American people know that innovation, choice, and competition
work," wrote Sen. Tom Coburn, R-Okla., in an archetypal opinion piece
titled "Competition Solves Health Care."

Give conservatives credit here: At minimum, this argument had a
logic to it, however flawed. Sure, it is belied by data - the Urban
Institute reports that private insurers spend up to 30 percent of their
revenue on administrative costs (read: salaries, paperwork, etc.) while
government programs spend just 5 percent, and polls show Medicare
recipients are far more satisfied with their health care than those in
the private system. But, in nonetheless claiming that the private
sector will always outperform the government, Republicans at least
presented an ideologically coherent (if fantastically inaccurate)
hypothesis.

That all changed, though, when Democrats this week began pushing to
let citizens buy into a government-sponsored health plan similar to the
one federal lawmakers enjoy.

The allegedly competition-loving GOP immediately stated its strong
opposition on the grounds that the initiative would begin "forcing free
market plans to compete with government-run programs," as congressional
Republicans lamented. While Rep. Roy Blunt, R-Mo., insisted that the
GOP remains "committed to common-sense solutions that promote
competition," he said his party is "concerned that if the government"
is permitted to compete, "it will eventually push out the private
health care plans."

Hold on a second.

Don't Republicans insist that "competition solves health care?" Yes, ad nauseam.

Haven't they been telling us that government programs are obviously worse than private health insurance? Yes again.

Then, don't they welcome a private-versus-public competition,
believing that the former will easily trump the latter? Well ... uh ...
no.

As I said, this is truly perplexing.

In one breath, GOP Jekylls say government medical plans will be
inefficient, inferior to private insurance and thus hated by Americans.
In another breath, Republican Hydes effectively admit that government
programs would be so efficient, superior to private insurance and loved
by Americans that they will attract most consumers and dominate a
health care competition.

Of the two assertions, of course, the latter is closer to the truth - and the GOP knows it.

Republican lawmakers received the new Commonwealth Fund report
showing that a public system would save consumers $2 trillion through
reduced premiums and lower administrative costs. They see surveys
showing the country overwhelmingly wants the government to create a
public health program - and they know that if given a choice, many
Americans will opt into that program rather than swim with the private
insurance sharks.

Republicans can't simply acknowledge these truisms, however,
because doing so would undermine the insurance industry that's filling
their campaign coffers. So instead, we get pro-competition,
government-is-ineffective "conservatives" working to thwart competition
and implicitly admitting they believe government will be too effective.

Yes, when it comes to competition, Republicans were for it before
they were against it. And this time, that confounding flip-flop doesn't
merely threaten a bumbling presidential candidate, it imperils a health
care revolution.

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