Opinion | Republican Health Care Lying Syndrome

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This public near-unanimity is one reason Medicare is so popular. Getting older — and thus joining a group with much higher average health costs than the rest of the population — is, after all, the ultimate pre-existing condition.

But there are only two ways to cover people with pre-existing conditions, and both are anathema to conservative ideology.

One is to have taxpayers pay the bills directly, which is what Medicare does.

The other combines regulation and subsidies. Insurance companies must be prohibited from discriminating based on medical history — a prohibition that must include preventing them from issuing bare-bones policies that will appeal only to those in good health — but that won’t do the job by itself. Healthy people must also be induced to sign up, to provide a good risk pool, which means subsidizing premiums for those with lower incomes and, preferably although not totally necessary, imposing a penalty on those without insurance.

If the second option sounds familiar, it should. It’s what countries like the Netherlands and Switzerland do; it’s also a description of, you guessed it, Obamacare.

But Republicans cannot admit that the only way to protect pre-existing conditions is to emulate Democratic policies. The party of Eisenhower, or even the party of Nixon, might have been able to do such a thing, but the party of Fox News cannot.

Nor, however, do Republicans dare admit that they have no interest in providing protection that a vast majority of voters demands. So they just keep lying.

You may, by the way, have heard talk about G.O.P. members of Congress opposed to Trump’s new health care push. But they share his goals; they’re just questioning his timing. The whole party still wants to take away your health care. It just hopes to get through the next election before you find out.

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