Healthcare Reform & Bobby Jindal - Cracks in the Republican Armor

There are two very different views of the Republican Party running loose on America’s streets at the moment. I bring them to your attention because I think they illustrate – aptly – why so many ordinary citizens are so far withdrawn from the modern political sphere.

The first stream – call it Liberal Frustration – is best exemplified by Paul Krugman’s October 4 column for the New York Times. In it, commenting on supposed Weekly Standard responses to the loss of the 2016 Olympic bid, Krugman Writes:

“Cheers erupted” at the headquarters of the conservative Weekly Standard, according to a blog post by a member of the magazine’s staff, with the headline “Obama loses! Obama loses!” Rush Limbaugh declared himself “gleeful.” “World Rejects Obama,” gloated the Drudge Report. And so on.

So what did we learn from this moment? For one thing, we learned that the modern conservative movement, which dominates the modern Republican Party, has the emotional maturity of a bratty 13-year-old.

But more important, the episode illustrated an essential truth about the state of American politics: at this point, the guiding principle of one of our nation’s two great political parties is spite pure and simple. If Republicans think something might be good for the President, they’re against it — whether or not it’s good for America.

Not content with pointing this out, Krugman seeks to deal w final blow to his opponents:

The key point is that ever since the Reagan years, the Republican Party has been dominated by radicals — ideologues and/or apparatchiks who, at a fundamental level, do not accept anyone else’s right to govern.

Anyone surprised by the venomous, over-the-top opposition to Mr. Obama must have forgotten the Clinton years. Remember when Rush Limbaugh suggested that Hillary Clinton was a party to murder? When Newt Gingrich shut down the federal government in an attempt to bully Bill Clinton into accepting those Medicare cuts? And let’s not even talk about the impeachment saga.

The only difference now is that the G.O.P. is in a weaker position, having lost control not just of Congress but, to a large extent, of the terms of debate. The public no longer buys conservative ideology the way it used to; the old attacks on Big Government and paeans to the magic of the marketplace have lost their resonance. Yet conservatives retain their belief that they, and only they, should govern.

The result has been a cynical, ends-justify-the-means approach. Hastening the day when the rightful governing party returns to power is all that matters, so the G.O.P. will seize any club at hand with which to beat the current administration.

It’s an ugly picture. But it’s the truth. And it’s a truth anyone trying to find solutions to America’s real problems has to understand.

Sobering words – and they explain a lot about why Democrats attempts (feeble as they may be) to elicit bipartisanship in the Senate over healthcare reform have failed miserably. And rightly so.

Now, contrast that with the Op-Ed piece written by Louisiana Governor Bobby Jindal in today’s Washington Post. This might be an example of Conservative Frustration - but we've seen so little of that its hard to tell. Jindal, a former health policy wonk, might be expected to contribute something new and fresh to the debate – especially since his party has contributed so little.

And he does – but in a very strange, almost liberal way. Writing about where we stand on healthcare reform, the Governor says:

A majority of so-called Republican strategists believe that health care is a Democratic issue. They are wrong; health care is an American issue, and the Republican Party has an opportunity to demonstrate that conservative principles work when applied to real-world problems.

Right off the bat, one has to wonder how he got into a party that has to be reminded – by one of its own supposed rising starts – of what its core principles are. I know the answer to that one: Jindal decided at some point (after I knew him in middle school) that he wanted to be a politician. And since Louisiana’s Democrats are still controlled by families named Long, Landreau, Edwards, and Morial, Bobby had to move to the Republican side of the ticket. One also has to wonder why supposedly free market loving Republicans want to continue to stand in the way of small business growth by keeping in place the current health insurance scheme, which is a failed market at best.

Taking off from there, the Governor then intones:

To be clear, the Republicans in Congress who have led the opposition to the Obama-Pelosi vision of health-care reform have done the right thing for our country. If they had rolled over, the results could have been devastating for our health-care system and our nation's budget.

But Republicans must shift gears. Conservatives should seize the mantle of reform and lead. Conservatives either genuinely believe that conservative principles will work to solve real-world problems such as health care or they don't.

I believe they will.

Again, note the reform call from within. Few other Republicans are standing on the national stage saying these things. And it remains to be seen if anyone will listen. But if the Republican Party is pinning its Presidential hopes on Jindal for 2012 or 2016, then perhaps the party needs to think long and hard about what he has to say.

Of course, like a good Republican (at least these days), Bobby then disappoints greatly with his list of the Top 10 Things Republicans need to back to create meaningful reform:

-- Voluntary purchasing pools: Give individuals and small businesses the opportunities that large businesses and the government have to seek lower insurance costs.
-- Portability: As people change jobs or move across state lines, they change insurance plans. By allowing consumers to "own" their policies, insurers would have incentive to make more investments in prevention and in managing chronic conditions.
-- Lawsuit reform: It makes no sense to ignore one of the biggest cost drivers in the system -- the cost of defensive medicine, largely driven by lawsuits. Worse, many doctors have stopped performing high-risk procedures for fear of liability.
-- Require coverage of preexisting conditions: Insurance should not be least accessible when it is needed most. Companies should be incentivized to focus on delivering high-quality effective care, not to avoid covering the sick.
-- Transparency and payment reform: Consumers have more information when choosing a car or restaurant than when selecting a health-care provider. Provider quality and cost should be plainly available to consumers, and payment systems should be based on outcomes, not volume. Today's system results in wide variations in treatment instead of the consistent application of best practices. We must reward
efficiency and quality.
-- Electronic medical records: The current system of paper records threatens patient privacy and leads to bad outcomes and higher costs.
-- Tax-free health savings accounts: HSAs have helped reduce costs for employers and consumers. Some businesses have seen their costs decrease by double-digit percentages. But current regulations discourage individuals and small businesses from utilizing HSAs.
-- Reward healthy lifestyle choices: Providing premium rebates and other incentives to people who make healthy choices or participate in management of their chronic diseases has been shown to reduce costs and improve health.
-- Cover young adults: A large portion of the uninsured are people who cannot afford coverage after they have "aged out" of their parents' policies. Permitting young people to stay on their parents' plans longer would reduce the number of uninsured and keep healthy people in insurance risk pools -- helping to lower premiums for everyone.
-- Refundable tax credits (for the uninsured and those who would benefit from greater flexibility of coverage): Redirecting some of the billions already spent on the uninsured will help make non-emergency care outside the emergency room affordable for millions and will provide choices of coverage through the private market rather than forcing people into a government-run system. We should trust American families to make choices for themselves while we ensure they have access to quality, affordable health care.

It all sounds great, doesn’t it? The problem for Jindal and the Republicans is that there is nothing new in here. Each of those ideas is already on the table in most, if not all, of the legislation in the Senate. I think all of those are in the legislation passed by the House. And most of it came from Democrats. So if the best that Republicans can do is to pick up Democratic ideas and champion them, then Mr. Krugman may be right, but for the wrong reason.

Republicans are engaged in the politics of spite, but only because they don’t actually have anything new to offer. Since that would show them to be the intellectually bankrupt Party – and drastically cut the chances of their return to power – they lash out. And America suffers for it.

If Republicans are to lead – and I think Jindal is right to call on his Party to do so – they need to LEAD, which means developing and championing the best ideas for America - regardless of the source of the idea, and with full attribution for the idea. To do less, frankly, is to demean the actions and successes of their predecessors, and that is as much a travesty as the state of current healthcare in this country.