Selling a bill of goods

Some forms of government policy are built of political concrete. Once done, they cannot be renovated, added to or even destroyed without immense cost. For that reason, they tend to go on much as they always have, for good or for ill.

That is unfortunate, but it is now a fact for Republicans with health care. We cannot simply get rid of what Democrats built and then perhaps, at some more convenient date, start over with a sounder design. All you get from a hasty demolition is a big pile of rubble.

That’s why I don’t understand what Republicans are trying to do with this bill. What do they think will happen after they proudly proclaim that they’ve repealed Obama Care — followed in short order by the complete implosion of the individual market?

Even if they think they have the political capital to get past voter angst, they’re not going to have much time to

spend it. Insurers will start to submit their proposed rates for 2018 in a few months. That is likely to become the effective deadline for any further tweaks, because if insurers think the collapse of the individual market is imminent, they will decline to sell into that market, and then the collapse will no longer be a forecast but a historical fact. And Republicans will be under immense pressure to fix it immediately — meaning, with a legislative process even hastier, and less-wellthought-out, than either the process of composing this bill, or the year-long saga of drafting Obama Care.

If Republicans want to actually do a radical renovation of our nation’s health-policy architecture, then they should get a reasonable estimate of the costs and actually build something enduring, while demolishing substantial portions of the ugly and unsustainable mess we currently have.

If Republicans cannot get up the will to bear those costs, then they should do nothing and start preparing their rebuilding strategy while they wait for Obama Care’s flaws to bring down the individual market on its own.