This is, to use a medical term, fucktarded:
The central difficulty is the seemingly irreconcilable differences between the goal of most Democrats, which is to expand health care coverage to as many Americans as possible, and that of Republicans, which is to push down government spending on health care. With costs rising sharply every year, those basic conflicts will remain, and policy solutions inevitably will require a bias toward one of those goals.
Obamacare is partly about extending insurance coverage to 30 million Americans (using an unfortunately market-friendly and therefore grossly inefficient formula calculated to gain Republican support, which PSYEEEECH, but whatever). It's also largely and explicitly about driving down government spending on healthcare.
Remember all that stultifying talk about "bending the cost curve?" Remember all that wearying horsetrading with various vested interests and their elected puppets as the Obamites busted ass to get a clean score from the CBO? All the boring but sweeping stuff under the hood about changing the incentive structure in healthcare provision from quantitative to qualitative measures? If THE WHOLE POINT wasn't to "push down government spending on healthcare," the fucker wouldn't have taken a goddamn year and change to push through and Obama wouldn't have blown every last bit of his political capital getting it there -- they just would have just issued an unfunded mandate, as Bush did with Medicare Part D.
The GOP? Their plan is, no less explicitly, the status quo, i.e., spiraling healthcare costs. In an ideal world, they'd also like to privatize Medicare, which, as Medicare Advantage shows, would do bupkus to control costs. But here's the Times lazily spinning the old tires in the narrative rut. "Liberals want more government, and conservatives want less spending! The eternal conflict, Yin and Yang, lalalalala..." Jesus Christ in a hospital gown riding a mechanical bull down Wall Street.
Look, Steinhauer, here's the deal: Republicans want their friends at America's Health Insurance Plans to make as much money as possible insuring as many healthy people as possible and as few sick people as possible. They're just fine with their doctor and hospital friends being paid per procedure rather than according to outcomes. They don't want any pointy headed nerds in lab coats telling their friends at PhRMA (bygones!) that the gummint won't pay for their pricey drugs just because they don't work any better than cheap generic alternatives.
And they don't really give a shit who pays the bill, because freedom. Also, too, death panels. But hey, why let that get in the way of a good story?
Crossposted at The Subversive Yuppie