Before the passage of the Affordable Care Act (aka Obamacare), America had not had a conversation about health care policy in decades. So it's understandable that many elected officials lacked knowledge about America's health care system and assumed it was performing as intended. From what they understood the health care status quo met the needs of the wealthy, professional and middle classes. And the poor, elderly and veterans had government-provided insurance.

But looks can be deceiving; individuals without any group-provided insurance were left to the mercy of the health insurance market. A market that left over 40 million of them uninsured. Obamacare came along and upset the peace of health care policy reform at the best and worst possible time.

It was the best time for an Obamacare-type law because about 40 million Americans did not have health insurance and Obamacare provided coverage to almost 40% of them. And it was the worst time for an Obamacare-type law because the country was and is so divided on most major public policy issues. Major health care reform was introduced in a politically polarized era that became even more polarized when Trump won the presidential election, and the Republicans won a majority of Senate and House seats.

More Than A House Divided

The Republican/conservative health care policy stance is much more splintered than it is among Democrats/liberals. Democrats want Medicare or Medicaid for All, universal health care or single payer. Or maybe they just want more federal funding for the Obamacare exchanges. It depends on which group of Democrats you ask, but at least they all want a health care reform policy that expands coverage to all Americans, Republicans disagree with Democrats on the very definition of universal access to health care. Remember when the Republican Party stupidly referred to health insurance/care access as "freedom?"

But idiotic catchwords aside, Republicans and conservatives also disagree with each other on the policy goals of health care reform. First, there is Senate Majority Leader, Mitch McConnell's (a real life villain) view that replacing Obamacare is the ultimate policy goal. He couldn't care less about the contents of any health bill and its impact on the public. His only health care reform policy objective is to convince enough Republican senators to pass an Obamacare repeal bill quickly.

Then there are Republicans like Paul Ryan who don't understand how health insurance works when he complains about young, healthy people subsidizing older sick people. Duh! Ryan tries to cover up his lack of understanding of health insurance and health care by insisting it is the public that does not understand how insurance should work. For him, insurance is another product that is customized to the individual's needs. Men don't need maternity care (unless their wives get pregnant, right)?

Similar to Ryan, there are Congressional Republicans like Bill Huizenga of Michigan who boasted about waiting a day to take his son to the doctor for what turned out to be a broken arm to avoid a large emergency room bill. He later stated that his personal experience was a bad example of how to use the health care system but stuck with the premise that the general public misuses and overuses health care services and need to become better consumers. Unfortunately, Bill has no constructive suggestions on how Americans can be better consumers without the price data they need that hospital and doctor associations lobby against providing.

And we can't forget Jason (in the House) Chaffetz, who borrowed his health care philosophy from the trope of the Ronald Reagan welfare queen. Jason wants us to stop buying expensive iPhones (lobster and steak) and use those funds to pay for health care because cancer treatment cost about $500.

Finally, there are the Republicans, Libertarians really, that have a more traditional view of health care policy. They don't want any able-bodied adults receiving government subsidized health care, at the expense of the disabled (this added malarkey makes Libertarians appear human). They are also concerned about over-regulation of the health care industry (over-regulation meaning all government regulation). And, lastly, they sense the inevitability of medical care price controls that will happen if health care becomes a right instead of a privilege (the stifling of medical innovation is palpable).

Conclusion

Yes, Republicans have a lot of health care policy camps, none of which will produce good policy. So I guess they have that in common.

Tags: obamacare, Trump