Every so often, I run into people who have sworn off voting, wouldn’t give two figs for either political party. Just fed up with “the both of them,” they say. Democrats and Republicans? Same difference.
Some days, I come close to the “same-difference” point of view myself. But only because with so many spin cycles in motion, it gets a little tricky trying to figure out what is what and who is where.
Example: Those of us who are even vaguely aware of the epic battle Ds and Rs have waged in the past couple of years know, without the shadow of doubt, that the brightest shining line dividing the camps has been — and remains — what to do about health care. President Obama has virtually staked his legacy as leader-in-chief (and that of his party, too, some would argue) on successfully rolling out the Affordable Care Act. The Republican Party has made it just as clear that over its dead body (perhaps not figuratively speaking) will “Obamacare” survive as the law of the land.
As differences go on health care, you’d think nothing could be clearer than: “Forward” versus “repeal and replace.”
But then the arguments cross party lines, and the blur factor creeps in.
You might recall that Republicans didn’t like it at all that Obama’s reform plan requires everyone to carry some health insurance. Or that to make the so-called individual mandate possible, he has committed the federal government, if state governments don’t do so, to set up a market exchange where private health insurance companies can compete for people’s business. The repealers have not been kind about this. They inveigh regularly against a government takeover, forcing companies to cover mandated benefits, interfering in the private market, micromanaging an industry that accounts for 18 percent of the gross domestic product.
The individual mandate and health-exchange plan does not affect seniors, who are covered by Medicare. Now, with details yet to come, consider the major changes so far proposed for Medicare by the Republican Party’s standard-bearers, presidential candidate Gov. Mitt Romney and U.S. Rep. Paul Ryan, his vice presidential nominee.
Their idea is to create a health exchange where private insurers would sell competing insurance plans for Medicare beneficiaries. The plans would have coverage that is at least equivalent to current Medicare offerings. The government would provide each beneficiary a subsidy (often referred to as premium support or a voucher). The amount of the subsidy would be pegged to the second-least-expensive plan on the exchange. If seniors choose more expensive plans, they would pay the difference out of pocket. Seniors would have an alternative plan under the Republicans’ proposal: the traditional, government-run Medicare.
A health exchange to drive competition for insurance plans? Same difference, should we say?
This might well be a good-for-the-goose-and-good-for-the-gander kind of argument. If exchanges are such a hot idea for a competitive health insurance market, why is the conservative opposition so set on repealing the Affordable Care Act with the very same driving mechanism? It would be interesting to hear how the Democrats, for their part, can argue against folding Medicare into the health-exchange legislation.
Recall the fights on Capitol Hill early during the health-reform process about whether or not to include a government-sponsored “public option”? The proponents lost that battle, but yesterday’s non-starter idea obviously has some political pull yet on the Republican candidates. How is keeping traditional Medicare different from the liberals’ dream of a public option as an alternative to balance private plans offered on the exchange?
Set aside that Romney rattled diehard repealers recently when he said he would repeal the Affordable Care Act except for the parts he, and everybody else, really likes. The remarkable thing is that in this very important respect, his plan would apply to Medicare a mechanism Obama has set in motion for all other Americans. Same difference.
Ofobike is the Beacon Journal chief editorial writer. She can be reached at 330-996-3513 or by email at firstname.lastname@example.org.