I read Joan's piece on the front page about Paul Ryan saying the GOP won't put any policy to their notion of healthcare reform as not at all surprising, since the republican simply doesn't care about this issue, never has and never will. Yet the left and Democrats have basically helped rebrand the republicans as serious people on healthcare and frame the beltway debate about the ACA being about disagreement on HOW to provide the care as opposed to what it should've been about...one side being against the idea that we should.
Now in defense of The left. broadly speaking, their was a rational basis for ceding that ground. Democrats and liberals, from the WH to Firedoglake, have basically redefined the republican party of the 90s as a party that was basically interested in fixing healthcare in the same way the ACA does, i.e. mandate, exchanges etc... Now the reason why the WH wanted to push this version of history was obvious, it simultaneously makes today's republicans look extreme and Obama look moderate. The reason liberals have pushed and internalized that narrative was to push the bill to the left, a worthy cause . IMO we should've always framed to republican party as they were/are...a party that has never been and will never be interested in healthcare reform. A party that is discredited on this issue. Below is a brief rundown of the actual history of the republican party on this issue.
Basically the root of this revisionist history by the left on republicans and their view of healthcare policy is rooted in a proposal that was drafted in response to Bill Clinton's healthcare push. During the outset of Clintons healthcare reform push, a group of republicans in the senate, led by John Chafee (a republican more liberal than his son, the current Independent governor of RI who voted against the Bush tax cuts and the Iraq war) made a strategic decision unify around a health care similar to the ACA. About 15-20 republicans signed on to that plan.What we forget is what happened after that plan was put on paper. The republicans put ZERO capital behind their plan, were not even close to having half their members supporting, never brought it on the floor, never held anything remotely close to a hearing or even some sort of event to demonstrate their seriousness. This was basically something put on paper that they felt, at the time, they needed to have at their disposal to point to rhetorically.
Furthermore, as soon as the party realized their chances of killing Clinton's plan had increased they basically took a similar confrontational approach as todays republicans and were not seriously engaging the subject. Sp when Bob Dole, a moderate republican, ran for President in '96 what was he touting?? Health savings accounts along with a removal of the employer tax credit for healthcare. A plan that Bush, Mccain, and Romney put forward, a plan that genuinely holds broad support among republicans and, most importantly, a plan that the CBO says does NOTHING for access and simply makes the group market like the individual market, basically taking the cancer in the system (the individual market) and spreading it.
Health Saving Account minus the employer tax credit is about as close to a prescription for fixing the market the republican party broadly supports. But even this destructive option is something they simply are passionate about, as evidenced by their priorities during the Bush years and today's GOP controlled House. The bottom line is healthcare reform has always been a democratic party goal and passion, and the republican party's focus on this issue as always been strategic and about positioning. The sooner we realize that, the better chance we have of discrediting the republican party as a serious party on this issue. Not that they're serious on any other issues, to be honest.