In her new role as one of two liaisons between the new crop of GOP faces in the House and the House leadership, Kristi Noem was set afoot yesterday to bolster support for the tax deal.
In doing so, she rightly pointed out that the tax package is merely just a first step and that we need to do more to spur growth, starting by repealing the "job-killing health care law."
This expression, the "job-killing health care law," is part of a package of Republican talking points (see, for instance, this post on John Boehner's blog just a day before Noem's comments).
Along with entitlement reform, replacing Obamacare is one of the most important things this country needs to facilitate growth. Notice I said "replacing," not "repealing."
Simply repealing the "job-killing health care law" will not create jobs. Ms. Noem acknowledged this today in the weekly Republican address, when she said that Obamacare needed to be replaced with "common sense" reforms that Republicans outlined in their Pledge this past fall.
The Plegde gets part of the way there, but it needs much more specificity and should focus on how growth-friendly alternatives are possible and hold together. Republicans should start talking about them soon and incorporating them into their leader-approved talking points. Presidential hopefuls should start driving this debate early.
Why? Two reasons:
- The key components of a robust replacement policy are already fairly well developed. They just need to be polished and sold publicly. So far, such components have not had a policy champion as, say, entitlement reform has had in Paul Ryan.
- Average American households saw their wages getting pushed downward by rising health insurance costs before Obamacare, meaning that repealing the law will just put us back in that broken situation. Without clearly articulated alternatives and growing popular support, we'll be stuck in that status quo for a long time.
So what to do? First, aspiring reformers simply need to read. Then they need to formulate how to say in simple terms what they have read. Then they need to popularize their message by getting out in front of the cameras.
Here's a good place to start: an article that Paul Howard and Stephen Parente wrote in National Affairs earlier this year. As they point out, many of the best ideas for reforming healthcare were already formulated in the Bush administration, but they were never sold well or were introduced too late to work.
There are five main components that Howard and Parente either address or touch on, which any Republican wanting to take up the mantle of reform should start assembling data on and talking about:
- Make it legal for insurance plans in different states to compete for our business. Currently, every state has to have its own plans according to its own laws. It's time to have health insurance made for the 21st century (as opposed to the current 19th-century-looking framework).
- Get rid of Obamacare subsidies and go with one defined voucher or credit that allows people to buy insurance. If the first reform takes place, shopping around for insurance will start to bring costs under control. Reformers need to embrace the idea that ending the current tax treatment of employer-provided insurance will help make insurance cheaper and more accessible to more people.
- Make it possible for people to form large insurance pools so they get the same "economy of scale" advantage as, say, federal employees. Again, if we take care of the first reform, this becomes easier. The fact that families and small businesses can't do this already is a grave injustice.
- End Medicaid's open-ended entitlement and start treating beneficiaries like American citizens rather than wards of the state. Make the competitive advantage of private insurance available to them through vouchers, and leave the open-ended entitlement for disabled individuals and those with serious chronic illnesses.
- Move Medicare in the "Paul Ryan Roadmap" direction by defining the contributions people will get, rather than just paying out their benefits, and means-test the program so those who need help the most have it. Medicare is practically an animal unto itself and needs to be part of a deficit-reducing entitlement reform plan, but it helps for health care reformers to talk about it in an informed way.
Only with reforms such as these will we find a health care system in America that complements growth, and even encourages, growth. Without them, even if Obamacare is repealed, our health care system will continue to be a downward drag on job creation.