Like a Sick Clock Without Health Insurance, Newt’s Right Again

Once again, Newt Gingrich is telling hard truth and offering good advice to Republicans. There is almost no chance the GOP will listen.

Just like a stopped clock, every once in a while Newt Gingrich gets something right. It’s happened before — when Newt exposed Mitt Romney’s vulture capitalism, defined Paul Ryan’s Medicare-killing budget proposal as “right-wing social engineering,” and called the super committee “about as dumb an idea as Washington has come up with in my lifetime.”

Now, Newt’s got something interesting to say about the GOP, health care reform and obstructionism.

Newt recently told a gathering of Republican party chairs and GOP operatives that, despite their determination to kill health care reform at any cost, Republicans have “zero”” ideas for replacing Obamacare.

“I will bet you, for most of you, you go home in the next two weeks when your members of Congress are home, and you look them in the eye and you say, ‘What is your positive replacement for Obamacare?’ They will have zero answer,” Gingrich told the Boston crowd, said a report from CNN.

Newt is a lot of things — too many to begin to address here — but “stupid” is not one of them. He knew his audience. He knew how they’d have responded if he simply said Republicans have no “replacement” or “alternative” to health care reform.

Of course, Republicans have offered alternatives and replacements for health care reform. Republican alternatives to health care reform have been elusive, but not entirely nonexistent. Republicans released a 219-page alternative to the Affordable Care Act in November 2009, and Paul Ryan reintroduced the GOP alternative to health care reform in his 2010 “Roadmap For America’s Future.” (For those keeping score at home, that’s 40 votes to repeal health care reform, and two attempts to replace it.)

There’s a difference between a mere replacement and the kind of “positive” replacement Gingrich emphasized. The Republican alternatives to Obamacare either went nowhere or have been “in progress” since January 2011. While the Republican Study Committee just announced that it will unveil the next GOP Obamacare replacement, it’s unlikely to be a “positive replacement.”

A “positive” replacement would have to accomplish everything that Affordable Care Act does — from expanding access to health coverage and medical care, to holding down health care costs — while keeping in harmony with conservative principles. That’s going to be difficult, given that millions of Americans being uninsured, and even dying because they can’t afford health insurance or medical care isn’t necessarily out of step with a principle of conservative health care reform defined by economist Tyler Cohen.

Republican governors are standing up for  a conservative health care reform principle articulated by conservative economist Tyler Cowen.

2. A rejection of health care egalitarianism, namely a recognition that the wealthy will purchase more and better health care than the poor. Trying to equalize health care consumption hurts the poor, since most feasible policies to do this take away cash from the poor, either directly or through the operation of tax incidence. We need to accept the principle that sometimes poor people will die just because they are poor. Some of you don’t like the sound of that, but we already let the wealthy enjoy all sorts of other goods — most importantly status — which lengthen their lives and which the poor enjoy to a much lesser degree. We shouldn’t screw up our health care institutions by being determined to fight inegalitarian principles for one very select set of factors which determine health care outcomes.

How do you get a “positive replacement” for Obamacare if that’s your starting point? You don’t. If you’re the GOP, you can’t. It’s safe to say America has spoken on health care reform. Obama and the Democrats ran on the issue in 2009, and won. After much discussion and debate — not to mention disrupted town hall meetings and death threats — Congress passed the bill. Obama and the Democrats ran on health care reform again in 2012, and won again. And this summer, the Supreme Court upheld the Affordable Care Act.

Republicans have had three clear opportunities to kill Obamacare, and they’ve lost every time. You’d think that would signal the end of the matter, right? Wrong. The ultra-conservative, tea party wing has been urging and even demanding that Republicans shut down the government if Obamacare isn’t “defunded.” (Something that can’t happen because most of the funding is mandatory — not discretionary — spending.)

It looks like Republicans are abandoning the shutdown strategy in favor of more debt ceiling hostage taking, but the last Republican to shut down the government still has some advice for the GOP.

“We have to get beyond being anti-Obama and we have to reconvince people that you can have hope in America,” said Gingrich, who ran unsuccessfully for president last year, told the gathering of party officials. “You don’t want to be the anti-left. You want to be the people offering a dramatically better future.”

That has to be hard for Republicans to hear. The President and Democrats can point to policies that have offered people “a dramatically better future,” like health care reform. Republicans are going to have a harder time offering solutions on issues like health disparities and high numbers of uninsured Americans, because modern conservatism doesn’t seem to define these conditions as problems that require solutions in the first place.

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Terrance Heath
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