Former President & CEO, INTEGRIS Health

A Maturity Conundrum

Published in The Journal Record
Wednesday, November 19, 2014

History tells us that sometimes people, ideals, and movements often take time to mature.  Woodrow Wilson, our 28th President, was christened Thomas Woodrow after his mother’s brother.  He was called Tommy for the first 25 years of his life.  It was only as an adult he decided that to be taken seriously he must refer to himself as Woodrow.

The recent congressional elections which were an overwhelming victory for Republicans place the Party in just such a maturity conundrum.  The Republicans campaigned vigorously on an anti-Obamacare platform, in many cases vowing to “repeal and replace” the bill.  What is interesting is that post-election polling showed there were as many people who felt the bill did not go far enough as those who felt it went too far.  While there are significant portions of the bill which are anathema to Republicans (such as the individual mandate), other portions including mandatory coverage for preexisting conditions, are universally popular.  The rollout of the health exchanges was poorly handled by the administration and gave weight to the bitter denunciation by the opposition.  The challenge the Republicans now have is do they present the President with a total repeal of the bill giving him the opportunity to demagogue on the Republicans lack of concern for consumer benefits.  After all, past Republican suggestions for health reform have been limited to requiring that health insurance be sold across state lines, and vague references to pursing “free market medicine.”

Up until now it’s been hugely advantageous for the Republicans to not have a plan and sit back and take shots at the early malfunctions of the bill’s rollout.  Let’s don’t forget that legislative initiatives that were once controversial move into the realm of universal acceptability over time.  Medicaid, our coverage for the poor, was slowly adopted by the states much like the health exchanges in the ACA.  Arizona did not adopt a Medicaid program until 17 years after the bill was passed.  I suspect it would be difficult for anyone to suggest today that we do away with the Medicaid program.  Republicans need to be very careful lest this political opportunity that opposition to Obamacare has given them doesn’t become a huge liability.

Replacing something with nothing seems to be a very risky strategy.

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