When asked what makes the world work, any self-respecting right-wing Republican knows the politically correct answer: competition! (With at least one exclamation point.) It is the paramount principle and universal solvent perennially touted by the right to cure whatever ails us -- in the abstract.
What they don't seem to like so much, in reality, is the competitive impact of the Affordable Care Act, which is forcing health insurance companies into a contested marketplace -- and seems to be driving down rates, state by state. The latest data arrived this week from New York, where insurance regulators announced that the new rates approved for 2014 will be 50 percent lower, on average, than current rates.
That stunning report follows similar news from California, where rates may drop by as much as 29 percent, as well as Oregon, Rhode Island, Vermont and several other states where the early indications show rates declining. Based on data compiled from 10 states and the District of Columbia, the Department of Health and Human Services says that 2014 premiums for mid-range (or "silver") health care plans in those states will be nearly 20 percent lower on average than its own earlier estimates.
The reason is simple, as anyone familiar with the American health care marketplace knows. Most states until now have had no meaningful competition among insurance companies -- and certainly nothing like the health insurance "exchanges" created by Obamacare to guide consumer choices.
In states that have actively promoted the exchanges, real competition is arising thanks to a marketplace that allows consumers to examine and understand choices, plans, and prices with ease. "That's a very different dynamic for these companies, and it's prodding them to be more aggressive and competitive in their pricing," explains Sabrina Corlette, a research professor at Georgetown University's Center on Health Insurance Reform.
For those of us who preferred (and still favor) a single-payer system providing Medicare to everyone, the compromises of Obamacare always provoked doubts about efficiency and fairness. Many liberals supported the Affordable Care Act reluctantly as a bad deal that was acceptable only in lieu of no deal.
But why do self-styled conservatives continue to hate health care reform with such ferocity? They may not care that it is truly "pro-life" and "pro-family," with the clear promise of saving thousands of lives annually among families that were previously uninsured. Yet they should surely appreciate a statute that promotes competition where there was none, improving services and reducing prices through freer enterprise.
Solving that conundrum exposes one of the ugly little secrets of the Republican right today -- and one of many reasons why that movement no longer merits the honorable title of "conservative." For what we can now observe in practice is that the Republicans perversely prefer a corporate marketplace without competition over a marketplace with competition overseen by government. While European conservatives have long accepted the need for strictly regulated markets, especially in health care, their American counterparts would rather allow corporate power to run unchecked at whatever cost.
It is an ideological preference that damages public health, ruins finances both public and private, and actually kills people every day, but it also swells corporate profits - which seems to be the primary value cherished by Obamacare's partisan opponents. Such destructive irrationality is what passes for "conservatism" in our time.
So the Congressional Republicans persistently attack and undermine reform, as they did by passing a resolution this week to delay the law's individual mandate. Rather than do anything productive, they proceeded with that meaningless action. And they did so despite warnings from the insurance industry that a delay would only increase rates for everyone.
Supporters of the Affordable Care Act have long reassured each other that the law would gain popularity someday. But if present trends continue, the public may come to realize as early as next year that the benefits of Obamacare greatly outweigh the flaws -- and that the law's opponents offer nothing to most Americans except higher rates, less coverage, and a sicker, sadder, harder life.