Health reform repeal should make conservatives nervous

Early last year, I wrote that conservatives should have been happy with health reform.

Maybe they just didn’t realize it yet, because they’re rejoicing after yesterday’s news of a federal judge ruling the individual mandate unconstitutional.

But by supporting repeal, conservatives should be careful what they wish for.

The fact is, the Affordable Care Act is a moderate piece of legislation. There’s no public option. It leaves private insurers intact. There is no expansion of Medicare.  Many traits of the Act could be found in prior, Republican plans for health reform.

I agree with the Washington Post’s progressive blogger Ezra Klein in his analysis, where he cites a column by Matt Miller:

By fighting the mandate needed to make private insurance solutions work, and doing nothing to ease the health cost burden on everyday Americans, you’ll hasten the day when the public throws up its hands and says, “Just give us single-payer and price controls.” Don’t think the anti-government wave this fall won’t reverse itself on health care if the most private sector-oriented health care system on earth keeps delivering the world’s costliest, most inefficient care.

Without the individual mandate, health reform cannot work. As Jonathan Gruber explains:

If insurance companies must charge the same price to people whether they’re sick or healthy many healthy people will view this as a “bad deal” and not buy insurance. This results in higher prices that chase even more people out of the market. The result is a “death spiral” that leads only the sick to purchase insurance at very high prices.

So, where will destroying the Affordable Care Act lead us? An increasing number of uninsured Americans and unabated, rising health costs. And worse, it is politically unlikely that anyone would address health care for decades.

Eventually, health costs would be so crushing, that the government would be forced to act — akin to their bailout of the auto industry. The most feasible solution then would be an expansion of Medicare, or Medicare-for-all — a true government takeover of health care.

That scenario is precisely why far left progressives want the current iteration of health reform to fail, which, strangely, is becoming a rare point that Tea Party activists and Huffington Post bloggers can agree upon.

 is an internal medicine physician and on the Board of Contributors at USA Today.  He is founder and editor of, also on FacebookTwitterGoogle+, and LinkedIn.

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