On the dog catching the car

I have an op-ed in Sunday's Raleigh, (N.C.) News and Observer on why repeal of the Patient Protection and Affordable Care Act (PPACA aka Obamacare) is about as bad an idea as a dog chasing a car actually catching the car. Then what?

We still need to do much more to address cost inflation, and here are a few ideas. Republicans especially have long discussed the need to reform the tax treatment of employer paid health insurance. They happen to be correct there. However, they have historically shown no offense when it comes to reform, only a strong expertise in ideological based defense. It is much easier to argue against something than it is to practically address the series of inter-connected problems of lack of coverage and cost inflation in the U.S. health care system. Many Republican ideas could improve the PPACA, especially in the area of cost inflation. Given that what has actually passed was essentially the Republican alternative to the Clinton plan plus a large Medicaid expansion, Republicans and Democrats have always been closer in policy reality than the strident anti-PPACA rhetoric suggested.

I am hoping Republicans are just saying whatever it takes to get elected, and will then seek to practically improve the bill. Again, if not, what happens if the dog actually catches the car....

Also, some of their rhetoric about rationing, especially as it relates to the Independent Medicare Advisory Commission seems to conveniently forget that the most comprehensive Republican Reform alternative, the Patients Choice Act, co-Sponsored by Richard Burr (R-N.C.), was the first to propose the idea. Adopting verbatim the Patients Choice Act language for such a commission is better than getting rid of it totally. Better yet would be for Republicans and Democrats to admit that there are limits to what can be done and to try and thoughtfully work through this fact.

I wonder if Senator Burr still likes his own bill? Haven't heard him mention it lately?