The Affordable Care Act’s rollout disaster has chastened Republicans as well as Democrats. Spooked by the uproar over cancelled plans, the GOP is rethinking its support for policies that experts predict would cause even more cancellations. The WSJ reports:
Some Republicans are now worried that a GOP proposal to begin taxing health-care benefits offered through employers—which would affect some 160 million Americans—would cause market disruptions far more severe and expose the party to its own political peril….“There’s an acknowledgment that massive overturning of the employer-sponsored system is something people just aren’t ready for,” said Douglas Holtz-Eakin, a leading Republican economist and chief policy adviser to Mr. McCain’s campaign.
This story underscores the fact that health care is a huge, extraordinarily complex system. The fantasy that there is one big, seamless reform that will make everything work beautifully leads a lot of people on unicorn hunts. Wonks of both sides might wish they could push through their pet reforms, convincing people to bear with lots of short-term disruption, but politics and public opinion just don’t allow that.The next steps in health care policy may involve thinking small. The federal government needs to rebuild public confidence in the concept of health care reform by way of discrete changes that make small but important improvements. In time, modest changes could point to larger, incremental approaches to guide federal policy. But lurching from one top-down reform to the next won’t get us anywhere.