Even if Republicans were able to magically repeal President Obama's health care law tomorrow, the United States still wouldn't have a free market health care system.
That's because even before Obamacare was enacted, the government already had direct or indirect control over most of the health care market through the mammoth government-run programs of Medicare and Medicaid, a tax code that is biased toward employer-based health care, thousands of mandates at the state level and a raft of other interventions.
That means to truly reform health care in the U.S., Republicans at some point will have to make a convincing case for alternative ideas.
It's not accurate to say that Republicans have never offered any alternatives to Obamacare, as there are a number of competing plans among Republicans. But GOP lawmakers haven't rallied around a single proposal and still struggle to make a case for them rhetorically.
As an example of what I mean, watch this video of Rep. Brad Wenstrup, R-Ohio, who appeared on CNBC's "The Kudlow Report" on Tuesday to discuss Republican health care alternatives.
Wenstrup started out okay enough by explaining the Republican Study Committee's health care proposal, of which he is a co-sponsor. I described the plan in more detail back in September, but one of the central aspects of the proposal is a provision to scrap the tax code's current preference for employer-based health care and replace it with a standard tax deduction for individuals and families.
At first, Wenstrup simply described the key features of the RSC approach. He said, "We would like individuals to be able to get a tax deduction by purchasing insurance on their own. That way it gives them much more portability. They can go from job to job and keep their insurance."
Then Larry Kudlow followed up by noting that one of the strongest arguments Obama has over Republicans is the ability to tout the fact that his program prevents insurers from denying coverage to individuals with pre-existing conditions.
Earlier in the interview, Wenstrup had mentioned the aspect of the RSC proposal that aims to extend coverage to individuals with pre-existing conditions through beefing up state high-risk pools. Instead of going into more detail about how this would work, Wenstrup responded, “We are in favor of taking care of those with pre-existing conditions. And let's be honest, if we can get these things in place and people get into insurance, then someday there won't be people with pre-existing conditions."
What followed just had me scratching my head.
"The other thing that would really help us along the way is if we would do things within the economy that got people into jobs that had insurance," Wenstrup said. "There's no greater social reform than having a job, but unfortunately within Obamacare, it's doing a lot of things that take people away from their jobs or into part-time roles."
Say what? Suddenly the Republican health care plan revolves around getting people employer-based insurance?
Just about a minute earlier, Wenstrup was making the case for why the nation needs to move away from the employer-based system, because doing so would allow individuals to take their health care plans with them from job to job.
On his congressional website, Wenstrup boasts of having obtained a medical degree and of having practiced as podiatric surgeon for 26 years and as a combat surgeon in Iraq. So it isn't as if he's a total novice when it come to the subject of health care.
But in this interview, he comes off as if he ran out of health care talking points and migrated into boilerplate economic talking points, even though the two arguments he made undermined one another.
If viewers were unfamiliar with Republican health care ideas going into this interview, what was their takeaway supposed to be? That Republicans are going to repeal Obamacare to improve the economy so that more people can get employer-based health care while Republicans also pass a new health care reform intended to move away from job-based coverage?
Republicans are going to have to learn to do a lot better if they're serious about repealing and replacing Obamacare.
UPDATE: Wenstrup spokesman Greg Brooks has pushed back against my post.
In an email sent Thursday morning, Brooks wrote:
In the interview, Dr. Wenstrup made two points, neither of which is incompatible with the other.
His first major point is simply highlighting the fact that, in the long run, our tax code should give Americans who purchase insurance on the individual market the same tax benefit that who receive insurance from their employer enjoy – as you delved into in your September piece on the legislation.
His second major point is that, in the shorter term, a robust economy, with increased hiring, will create more opportunities for Americans to receive health insurance, whether employer based or individual. In the current marketplace, it is undeniable that a full-time job is one of the best ways to get health care coverage.
Even the Republican Study Committee, when explaining the standard deduction in HR 3121, says: "With the tax benefit tied to simply having insurance, workers will be empowered to seek out coverage that is right for them and their family, and employers are encouraged to engage their employees in discussions about the right mix of wage and benefit compensation."