Conservatives should love the Affordable Care Act


And progressives should want health reform to fail.

No, you read that right.

Counter-intuitive?  Let me explain.  As the fate of the Affordable Care Act hangs in the balance in the Supreme Court, both progressive and conservative pundits have been working overtime to discern the future of health reform.

The traditional thinking is that progressives direly want health reform to move forward, and conservatives can’t wait to repeal the Act.

Both have it wrong.

I wrote back in 2010 that health reform repeal is the rare point that Tea Party activists and those on the far left can agree upon:

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.

The problem with repeal is that we will have to wait several decades before health reform is approached again.  In a piece by progressive columnist Ezra Klein, he notes that after the Clinton plan failed in the 1990s, it was 18 years until Congress touched health care again.

I wrote in CNN recently that the Affordable Care Act is seriously flawed.  Hardly enough is proposed to shore up our primary care foundation, and the broken malpractice system is barely touched. But it does give help to patients who need it the most, and it’s a start that can be built upon.

Ironically, by keeping the private insurance industry intact, the current iteration of health reform’s roots lay in the hands of the conservative Heritage Foundation.  It’s baffling to me why conservatives would want to repeal the Act, which would make a Medicare for all, single-payer system much more likely down the road.  And that’s a scenario far more nightmarish to those on the right.

So, instead of a more ideologically pure vision of reform, conservatives should want the Affordable Care Act to pass.

By celebrating the potential for repeal, conservatives should be careful what they wish for.

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


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