This, this, is the Republican Party’s health care problem. It isn’t that conservative ideas about health policy don’t exist, and it isn’t that they won’t work. It’s that right now the feasibility question is purely academic, because even after five years of debating these issues, and despite Eric Cantor’s best efforts, there still aren’t enough Republican lawmakers willing to take even the smallest of steps toward putting those ideas to the test. This means that no matter how much of a “bureaucratic nightmare” the implementation of the current health care law turns out to be, liberals at least have this ace in the hole: When it comes to health care reform, there is still no politically realistic alternative to their approach.I'd agree that the GOP certainly has a "policy problem," but I'd argue if anything the situation is worse than how Douthat characterizes it.
Political scientist Jonathan Bernstein recently pointed out at Salon that GOP legislators just don't seem to care about policy outcomes at all. In the House of Representatives the GOP has only filled one of the 10 traditional slots reserved for high profile bills:
Which leads to the embarrassing fact that no one seems to have noticed about this year’s House Republicans. Over 100 days into the current Congress, their agenda is … almost completely empty.This isn't because Republican voters or conservtatives in general don't care about public policy, they do! It's because the incentives inside the GOP have become so perverse, that doing the hard work of actually writing a bill will get you nowhere:
In fact, of the 10 reserved slots, there’s only one bill filed. That’s H.R. 3, a bill to force the building of the Keystone XL pipeline. Even that is pretty minimal – it’s far more of a symbolic position than it is an energy policy. And even that took until March 15 to introduce.
My guess is that the Republican-aligned partisan press is just so easy for Republican politicians that they’ve all become lazy. If all you have to do to be a favorite guest on Fox News or on syndicated conservative talk radio is to mutter something vague about Benghazi and make a teleprompter joke, what’s the incentive of doing the hard work of actually writing a bill?Indeed, Ted Cruz has been making hay by introducing nothing and instead claiming responsibility for things he had nothing to do with.
While it's true that some conservative intellectuals and think tankers have been kicking around ideas for how to change America's health care system, I'd argue at best this is only a symbolic victory for folks (like Douthat) who want to see a more functional GOP. The fact that some people get paid to churn out white papers at Cato or Heritage just doesn't count for much when the reality in the GOP Congress is that no one cares about policy. Which is why I predict that we will see more and more symbolic votes on things like "repealing Obamacare" and nothing when it comes to the "replace" side of the slogan we've been hearing for four years now.