Blog Ipsa Loquitur

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Craig Garthwaite, a professor of strategy and healthcare at Northwestern University, on why replacing Obamacare is so hard: it’s fundamentally conservative.

Republicans are engaged in a brutal civil war between hard-liners and moderates as they struggle to craft legislation to repeal and replace Obamacare. The episode invites an almost existential question for the GOP: Why, after seven years of nearly endless war against Obamacare, is the party unable to deliver a more conservative policy that provides access to health care to a similar number of Americans?

As a life-long Republican who has spent months contemplating this question, I’ve come to an answer that will be hard for many conservatives to swallow: Passing an Obamacare replacement is difficult because the existing system is fundamentally a collection of moderately conservative policies.

​Garthwaite’s op-ed is a nice recitation of the philosophical reasons conversatives should be comfortable supporting a market-based healthcare system like Obamacare. However, it doesn’t delve into the parentage of Obamacare, or why the DNA of the bill is so amenable to conservative principles.

For example, the right-leaning Heritage Foundation think tank consistently advocated for implementing the sorts of health insurance exchanges core to Obamacare, as recently as 2006. As governor of Massachusetts, Mitt Romney signed into law and implemented health insurance reform that looks awfully like Obamacare’s.

Fact is, there are a lot more reasons Congressional Republicans could support health care than ‘Reagan thought government could do stuff okay sometimes.’