Commentary

GOP Health Proposals Sickening

Why is it that when it comes to the economy, Republicans can’t seem to do anything right?

Sure, President Bush and a GOP Congress cut taxes. But as any good economic conservative knows, the real measure of the size of government is not taxes but government spending. Those same Republicans have been on a spending spree that would make Lyndon Johnson blush.

Conservatives raised a stink at the prospect of abortion-rights supporter Sen. Arlen Specter (R-Pa.) becoming chairman of the Senate Judiciary Committee. But where is the outrage when Senate Finance Committee Chairman Chuck Grassley (R-Iowa) harasses oil companies for (gasp!) making a profit, demands stricter drug regulation or tries to ban specialty hospitals?

In fact, nowhere is the GOP more adrift than on health care. Any good economic conservative will also tell you that Medicare is a ticking tax bomb. But Republicans don’t even talk about reforming Medicare anymore. They’re too busy defending their new drug entitlement.

Or expanding the federal government in other ways. This week, the Senate is expected to vote on Wyoming Republican Sen. Mike Enzi’s “association health plan” legislation, which would replace state health insurance regulations with federal rules.

Or launching even more direct assaults on economic freedom. Massachusetts Gov. Mitt Romney just signed a bill that requires Bay Staters to buy health insurance under penalty of law. Can we look forward to being greeted at the border with, “Welcome to Massachusetts - your health papers, please”?

The single positive step that Republicans have taken in health policy was almost a mistake. Party leaders attached health savings accounts (HSAs) to the Medicare drug entitlement just to buy off the few ornery conservatives who hated the rest of the package. This year, almost on cue, Chairman Grassley dismissed the idea of expanding HSAs.

Republicans used to bill themselves as the party of limited government. No one takes that claim seriously anymore.

If the party has lost its compass, then what is guiding the GOP? It’s an answer that only a Democrat could love.

Grassley’s efforts to shut down specialty hospitals undermine market competition. But that works out for the big hospitals that would otherwise lose business.

Republicans ardently defend their new Medicare drug program, which provides windfalls to drug companies and large employers. General Motors will net $4 billion from it. Ford will net almost $2 billion.

Enzi’s bill violates the bedrock GOP principle of federalism. But that works out just fine for the 177 Washington trade associations that want to offer firms health insurance as a membership benefit, and who need federal legislation to do it.

Romney’s new law includes not just that individual mandate but also some hefty tax increases. So its main constituencies are the media and the Massachusetts Legislature itself. Plus it gives a boost to a presidential hopeful in need of good press.

The shame of it is that the GOP has any number of free-market proposals under which it could march. The bipartisan Medicare reforms debated in the 1990s are needed more than ever, and would solve Grassley’s concerns about “unfair” hospital competition.

Rep. John Shadegg (R-Ariz.) has a health insurance proposal that would give the trade associations everything they want, but shift control from state regulators to families and employers instead of the feds. His Health Care Choice Act of 2005 would also reduce the number of uninsured in Massachusetts.

Those proposals languish, because the Republican Party has lost its compass and lets just anyone man the rudder. Some Republican needs to rediscover that compass, and take command of the helm.

Michael F. Cannon is director of health policy studies and co-author of Healthy Competition.