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Please begin with an informative title:

Republicans hate the Affordable Care Act.  A lot.  They've tried to repeal it in Congress something like 40 times.  In the states, Republican governors and legislatures are doing everything they can to prevent implementation.

I mean they really really hate it.  I could lift a Douglas Adams quote and insert it here, but even that wouldn't be a good illustration of how much Republicans hate the ACA.  how much do they hate it?

Enough that in their quest to repeal it, they're going so far as to propose a single payer system.


You must enter an Intro for your Diary Entry between 300 and 1150 characters long (that's approximately 50-175 words without any html or formatting markup).

You heard that right.  A single payer system.  

Robert W. Patterson was a welfare advisor to Pennsylvania Governor Tom Corbett.  He is also the editor of The Family in America: A Journal of Public Policy.  Here is part of what he writes:

He begins with a VERY blunt assessment of how Republicans view the health care debate.  Especially by criticizing Republicans for continuously re-litigating the debate and telling them to get over it.  And then he offers an assessment of not only the system itself, but how people think of the system

Yet GOP members of Congress, pushed by conservative think tanks, continue to mount a rearguard action against Obamacare while advancing the notion that nothing is broken in the health-care system that free-market reforms cannot fix.

Discarding Obamacare's regulatory baggage and delinking insurance from employment would be well and good, but Republican policy experts are under the delusion that the health-care sector can function as a competitive market, as if consumers can bargain with insurance carriers, mega-hospitals, pharmaceutical giants, and medical specialists. Good luck with that.

Meanwhile, retirees and near-retirees express no enthusiasm for the designs of House Budget Committee Chairman Paul Ryan (R., Wis.) to turn Medicare into a "premium-support" system, especially when such downgrading is couched as budget-cutting.

It's time for Republicans to dump their policy advisers, start thinking about the anxieties of ordinary Americans, and construct a viable health system that beats Obama at his game.

(diarist emphasis)

So what's his plan?

   First, congressionally charter Blue Cross-Blue Shield as a monopoly to provide basic coverage to all Americans, except retirees. And grant the regulated nonprofit authority to impose payer-fee schedules on providers of routine care and services, much as Medicare does.

    A utility-style Blue Cross-Blue Shield covering all working-age Americans and their dependents would offer enormous administrative economies of scale and an insurance pool of unprecedented size. By trumping state regulations, the plan would be relieved from paying for luxuries like aromatherapy, Viagra, sex-change operations, hair implants, birth control, or elective abortion. Nothing would preclude other carriers from selling supplemental insurance for medical non-necessities, purchased by individuals at after-tax rates.

    Jointly funded by a modest payroll tax and shale-oil severance fees, this utility would not only replace all nonsupplemental health-care plans, but also Obamacare, state exchanges, much of Medicaid, and the State Children’s Health Insurance Plan.

Essentially, this is a single payer health care plan.  Now, there are some problems with what he proposes.  You will notice right off the bat that he calls contraception and elective abortion "luxuries" which won't be covered.  I guess that's his way of guaranteeing Republican support.  One wonders what exactly WILL be covered in this "regulated non profit".  He says "routine care and services", but what does that mean?  In Congressional sausage-making, the lobbyists of AHIP will have much to say on that subject.  Especially as they will offer "supplemental insurance for medical non-necessities, purchased by individuals at after-tax rates."  With of course the exceptions of any kind of women's reproductive health services.  After all, these are Republicans.  

Another problem is the elimination of most of Medicaid and SCHIP.  What's the guarantee that these people who need these services will be able to afford them under the new system? After all, even though this will be a "regulated non profit", you can bet your sweet bippy that there will be enough loopholes for someone to be making a buttload of money.

A third problem is the funding.  "Shale-oil severance fees"?  I guess to a Republican, it's frack now, frack forever.  

These problems aside, the point he makes is an important one. He wants the Republican Party to regain the relevance it once had.  This can be a game changer.  Hell, with a few tweaks in coverage, regulation, and in how it's paid for--like by eliminating corporate tax loopholes instead of shale-oil severance fees--this can be introduced by a Blue Dog in the House, with a "saner" Republican as a co sponsor, as a "repeal and replace" to the ACA.  And if Republicans take the lead, this can put them in relevance in the health care debate again.  Particularly in 2014, as the ACA kicks in fully and the exchanges are up and running for the first time.  

Because we know the strategy of Republicans--Sabotage the ACA so much that in 2016 the people will elect Republicans to repeal it.

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