A tin ear on health care policy

One of President Barack Obama’s cherished conceits is that disagreement with him can have no rational basis. It was the theme of his most recent speech in defense of his health care law.

Obamacare has substantially increased the number of Americans who have health insurance.

The core problem with his speech was not that he overestimated the merits of Obamacare. It’s that he refused to acknowledge that conservatives have reasonable disagreements with him about the direction of health care policy.

Obama believes that only comprehensive insurance policies are real insurance. Conservatives generally believe, by contrast, that people should be free to buy cheaper policies that protect them only from financial catastrophes arising from their health needs.

- Advertisement -

Obama says people having trouble buying insurance on Obamacare’s exchanges should receive more generous subsidies. The conservative alternative – relax regulations that make insurance unaffordable for them – is unacceptable to him because it would be a retreat from comprehensiveness.

Obama claims that Republicans have offered no alternatives to the health care law. They have in fact outlined their own far-ranging plans for health policy.

A lot of conservatives want a less regulation-heavy system, where everyone has access to relatively cheap catastrophic policies. Obama’s speech offered no reasons for them to stop wanting that.

This doesn’t mean that Republicans should insist on making no changes to health policy that fall short of replacing Obamacare. And, in fact, they have not insisted on that.

They have advanced legislation to fix what they see as specific problems with the law, such as its medical-device tax and its prohibition on some people’s existing health policies.

Obama resorted to a number of ill-considered analogies in making his pitch. One likened Obamacare to a “starter home”: “It’s a lot better than not having a home, but you hope that over time you make some improvements.”

Sometimes, though, you decide that you want a different kind of home altogether, and work until you can move there. •

Ramesh Ponnuru is a Bloomberg View columnist.

No posts to display