The Democrats' plan would displace tens of millions of happily insured Americans and exacerbate the worst elements of the current system.
Such a reform would allow small-business employees to select their insurance in organized, state-facilitated marketplaces in the same way that federal workers can choose their coverage today. Workers would be making the insurance selection, not firms, from a menu of competing offerings. Workers in medium and larger firms would maintain the same coverage they have today--although the switch to tax credits would add a new level of cost-consciousness to the design of existing employer plans--and as the individual insurance marketplace developed around workers in smaller firms, it would help reduce public anxiety about a gradual transition away from employer-based health care.
Such a Republican initiative would demonstrate that we can build on what is best (and well liked) about the current system--high quality care, doctor and patient control--while adding options onto the existing employer-based structure that encourage gradual and sensible moves toward a genuine individual insurance market.
Conservatives can make it clear they support reform. But they must make it even clearer that the Democrats' plan would displace tens of millions of happily insured Americans and exacerbate the worst elements of the current system: gross inefficiency, high costs, and bureaucracy. President Obama and his congressional allies are pursuing a mammoth, complex, hugely expensive, ill-designed reform that is not likely to be popular when understood. Conservatives have a very real chance at stopping it if they highlight its key weaknesses and supply a superior alternative.
James C. Capretta and Yuval Levin are fellows at the Ethics and Public Policy Center. Capretta is also a consultant to private health insurers.