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Hullabaloo


Saturday, April 27, 2013

 
If they're nuts, they're nuts. And they're nuts.

by digby


I'm a little bit confused by something. The consensus among the savvy insiders is that the Republican party of today represents an unprecedented opposition, so extreme in ideology, tactics and strategy that even a Democratic White House and a majority in the senate is completely paralyzed by its radical obstructionism. Nothing can be done, nothing anyone says or does can change it (except, perhaps, make sure the American people see that they are grown-ups.)

And yet, many people also believe that they are just like Republicans have always been.  Here's Ezra writing about Obamacare this past week:
  April 25, 2013 11:53 AMRepublicans Will Clobber Obamacare Until They Hug ItBy Ezra Klein

He says all this is just short term politics and that they will eventually go along because that's what they've done in the past. And yet, I also hear they are sui generis and something more akin to the Southern Democrats of the 1850s.

Now Ezra does show how they will do it in a way that's quite interesting:
Don’t believe it? Some Republicans are already arguing that Ryan’s Medicare premium support plan simply brings Obamacare to Medicare. “The great irony of Obama’s triumph, however, is that it can pave the way for Republicans to adopt a comprehensive, market-oriented healthcare agenda,” wrote Avik Roy and Douglas Holtz-Eakin, two influential Republican policy advisers. They argue that “both Representative Paul Ryan’s ‘premium support’ proposal for Medicare and Obamacare’s exchanges are modeled on the Swiss system,” and that Republicans should push to have Medicare beneficiaries “gradually migrate into the exchanges’ premium-support systems.”

See? Republicans can go from arguing that Obamacare should be repealed to arguing that it needs to be expanded in a flash. But not until they’ve squeezed every political benefit from making its implementation disastrous.
Why interesting? Well, here's Ezra himself from a couple of years ago:
If Republicans can make their peace with the Affordable Care Act and help figure out how to make the Affordable Care Act's exchanges work to control costs and improve quality, it'd be natural to eventually migrate Medicaid and Medicare into the system. Liberals would like that because it'd mean better care for Medicaid beneficiaries and less fragmentation in the health-care system. Conservatives would like it because it'd break the two largest single-payer health-care systems in America and turn their beneficiaries into consumers. But the implementation and success of the Affordable Care Act is a necessary precondition to any compromise of this sort. You can't transform Medicaid and Medicare until you've proven that what you're transforming them into is better. Only the Affordable Care Act has the potential to do that.
I guess we can look forward to bipartisan comity on that one.

I have no idea if Republicans are going to accept Obamacare in the future, much less if they'll decide it's at least a good way to destroy Medicare so they might as well go for it. Maybe they will. Or maybe they see how successful they've been at getting the Democrats to willingly propose cuts to Social Security and Medicare and will just wait for them to do the same thing to the health care reforms. Indeed, Obamacare will be much easier to dismantle bit by bit, starting with the funding for the "welfare" portions of the plan like Medicaid. It's easy to imagine that we will find ourselves unable to afford to pay subsidies at the levels currently prescribed or that the exchanges need to be "deregulated." There are lots of ways to skin that cat.

Anything could happen. But the complaisant assurance that, of course the Republicans will eventually go along because they've done so in the past just seems short sighted to me. Sure, they like using these things as political battles. But the fact that the programs have continued isn't a sign that the Republicans love them underneath it all. It's a sign that they just haven't figured out how to end them without being destroyed politically. That's why they were designed as "entitlements" and not as complicated subsidized marketplaces. There was a time when people understood that the only way to ensure that a program was safe from these property worshiping conservatives was to make sure that everyone knew who was sending their checks and paying their bill: the government.

The problem really isn't in thinking that the Republicans aren't really as nuts as they seem right now, it's in thinking that they haven't always been pretty nuts. It's just that their power to act on their nuttiness waxes and wanes with the power of the conservative faction in politics. And I don't think there's any crystal ball that can accurately predict how that's going to go.


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