SAN DIEGO – If there’s one thing we know for sure, it’s that Republicans are against Obamacare.
Except that, according to Washington Post columnist Ezra Klein, they’re really not.
“If McCain had won the 2008 elections, we’d still be talking about a health care reform bill right now, with all the same provisions,” he told the audience at his Benefit Selling Expo keynote presentation on Tuesday. “The only thing different would be we’d be calling it McCainCare.”
Chalk it up to politics. Klein posits that Democrats and Republicans (who introduced a precursor to the Patient Protection and Affordable Care Act in the 1990s) mostly agree when it comes to health care policy. What they’re really fighting about is power.
“A lot of the fights we have about policy in Washington are really just about who wins the next election,” he said. “Washington’s a much weirder place than we give it credit for.”
Unfortunately, election-driven policy stances don’t usually make for great policy, Klein said. And exhibit A is PPACA.
If PPACA lived in a nonpartisan world, “2014 should be the year it rolls out and we figure out what goes right and fix whatever goes wrong,” Klein said.
But we live in the real world, where 2014 is an election year. Republicans are hoping an Obamacare failure helps them ride to victory in the midterms; Democrats are hoping for the opposite. It’s a situation that doesn’t exactly breed compromise, Klein said.
“What we could end up with, rather than a good Affordable Care Act or no Affordable Care Act is just a badly implemented Affordable Care Act,” Klein said. “And that’s what I worry about.”
That leaves a lot of uncertainty about health care in Washington as well in the rest of the nation. “Anyone who’s being definitive to you about health care right now is lying,” he said.
And clarity isn’t likely to come any time soon. Because in addition to the Affordable Care Act, the two parties also are divided on the future of Medicare, the likely subject of the next health care-related battle in Congress, Klein said.
Republicans want to privatize the program and let the free market go to work, while Democrats want to expand it and use its purchasing power to drive down costs. See the problem?
“The difficult thing about those two positions is that there’s no compromise between them,” Klein said. “You can’t split the difference. I worry that we’re just looking at true and fundamental gridlock in Washington. It’s very hard to see, in the short term, how we move forward with health care.”