From this Tuesday's The Rachel Maddow Show with guest host Ezra Klein, Klein lays out very plainly why Republicans don't think our health care system and insurance system in the United States needs reform. As Klein noted, their leader in the Senate,
July 5, 2012

From this Tuesday's The Rachel Maddow Show with guest host Ezra Klein, Klein lays out very plainly why Republicans don't think our health care system and insurance system in the United States needs reform. As Klein noted, their leader in the Senate, Mitch McConnell laid out very plainly on Fox News Sunday this weekend the fact that he and his party do not think the number of uninsured Americans is a problem they need to be concerned with.

EZRA KLEIN: But before that, I have to begin with a confession. You know Mitch McConnell, kind of a jolly guy. He`s a Kentuckian. He leads the Senate Republicans.

He is my favorite politician by far, and not just because of his good looks or his Southern charm. It`s because Mitch McConnell is the most honest man in Washington.

You ask almost anyone else in a position of power on Capitol Hill why they`re doing, what they`re doing, and you get spin, spin, and more spin. You know, they`re reaching across the aisle to make the country better, because freedom is the most important freedom, that any freedom and American value, and then you think about the children and their freedom, and et cetera, et cetera.

Meanwhile, they just got done 10 minutes before that meeting with six mega donors and the way they`re voting on the amendment because they`re settling a score they have been nursing since the 2005 budget fight.

Mitch McConnell is not really like that. He tells you what`s going on. When he speaks I have learned to listen. In fact, of every politician and I`m not kidding about this, he`s literally the one I listen to the most closely because his mixture of real power and frankly honesty maim hick the best guy to what is going to happen next in the Capitol.

A few examples, back in October 2010, Major Garrett of "The National Journal" sat down with McConnell to talk about what Republicans would do if they took back Congress in the fall. McConnell didn`t Garrett he wanted compromise or a new tone or a renewed spirit of cooperation and partnership or any of the warm and fluffy things you tend to hear politicians say.

No, he told Garrett, quote, "The single most important thing we want to achieve is for President Obama to be a one-term president." Ouch.

So partisan, sure, but honest. If that would have been all you knew about the Republican Party, you could have predicted the last two years in Congress almost perfectly.

But, of course, most people didn`t predict it perfectly. They have been puzzled by Republicans who seem unwilling to touch anything with a Democratic name on it, up to and including bills the Republicans have supported and even come up with themselves in the first place.

But you know what? McConnell explains that whole thing to us, too. In January 2011, he gave an interview to "The Atlantic" in which he said, "We worked very hard to keep our fingerprints off these proposals because we thought that the only way the American people would know a great debate was going on was if the measures were not bipartisan."

You know what? McConnell was correct. I think that`s actually one of the most profound things anyone has said about politics.

What he understood was that what makes a bill bipartisan is not the ideas in it or the spirit in which it`s offered. It`s whether any legislators from the other party sign on. And if none of them do, then by definition, no matter how moderate the ideas in the bill are, the bill is partisan.

So by keeping his members off the major bills, he makes each and every one of those pieces of legislation into a partisan bill, and he destroyed the president`s hope for image as a bipartisan compromiser.

This weekend on FOX News, McConnell gave another remarkably honest interview. For years now, Republicans have been saying repeal and replace, repeal and replace, you probably heard it. That is their health care plan.

But they haven`t come together behind anything that would actually replace the Affordable Care Act and cover a substantial act of the uninsured. Chris Wallace asked McConnell why. In fact, he asked McConnell why three times.

And by the third time, McConnell`s limited patience gave out and he got real.


CHRIS WALLACE, FOX NEWS: One of the keys to Obamacare is it will extend insurance access to 30 million people who are now uninsured. In your replacement, how would you provide universal coverage?

SEN. MITCH MCCONNELL (R-KY), MINORITY LEADER: First, let me say the single best thing we can do for the American health care system is to get rid of Obamacare.

WALLACE: If I may, sir, you talked about repeal and replace. How would you provide universal coverage?

MCCONNELL: I`ll get to it in a minute.

WALLACE: What specifically are you going to do provide universal coverage to 30 million people who are uninsured?

MCCONNELL: That is not the issue. The question is how can you go step by step to improve the American health care system. It`s already the finest health care system in the world.


KLEIN: That is not the issue. It is already the finest health care system in the world.

You listen to that and it`s clear there is no replace agenda. Not a real one, just repeal.

And the reason there`s just repeal is key Republicans don`t think the uninsured are the issue. They don`t think our health care system is, in fact, all that broken. It`s the best in the world, remember.

This is about tweaks, improvements, not a national crisis of 50 million people who can`t get care when they need it.

Look, you could say, Ezra, your love, your adoration for Mitch McConnell is blinding you to the truth. He`s an outlier. Republicans do want to fix the health care system.

To which I say, oh, yes?

Here is Eric Cantor on "MORNING JOE" on Friday.


TOM BROKAW, NBC: It seems to me that the Republican Party then has to have some kind of a framework of an alternative to what they`re talking about because whatever else we think about health care, everybody knows that financially the system is broken. You can still get cured here in ways you can`t in others and get treatment, but the cost system is kind of a Ponzi scheme.

So, my question again to you, Congressman, is when will we see a Republican plan that would replace more meritoriously the Obamacare plan that you`re so unhappy with?

REP. ERIC CANTOR (R-VA), MAJORITY LEADER: Tom, you knew back in 2009 when the Obamacare bill was being considered on the House floor, we put forward our alternative. To say we don`t have a replacement is not correct.


KLEIN: Aha, so they do have a replace. What Cantor is saying is he`s got a full plan, like right now, you go read it. It`s the same plan they voted on in 2009. It`s sitting out there. You can download it on the Internet, which we did today at the RACHEL MADDOW SHOW.

And we went through it, and as it turns out, there`s not much to see. There were four main ideas in the Republican bill. One was tort reform, to which, eh -- another was allowing insurers to sell across state line.

Now, this is a big Republican idea here and we should go through it real quick. Right now, your state regulates the insurance you can buy. If Aetna doesn`t follow the rules you lay down by the people you elected to represent you in the legislature and the governor mansion, they can`t sell in your state.

But that is not how all markets for all products work. If you ever notice how your credit card bills come from South Dakota or Delaware, it`s because credit card companies can sell across state lines. And so, they cut deals with South Dakota and Delaware in which those states gave them very, very, very lax regulatory environments and the credit card companies put their headquarters there.

So, all Aetna would have to do is follow the rules in whichever state they wanted which would be whichever state had the fewest rules. So, classic race to the bottom.

A third was -- a third idea in the Republican bill that is was high risk, where sick people can go to get insurance with other sick people. It`s a stopgap measure you do if you don`t want to end discrimination of people with pre-existing conditions. And Republicans don`t want to do that, or at least they didn`t want to do it in this bill.

A fourth idea was branch to states to help them experiment with reforms on their own.

Look, whether you like the changes or you hate them, they`re not big reforms. They`re tweaks. They are adjustments. They are small, tiny changes to the existing law. And they`d have a small effect.

The Congressional Budget Office, the nonpartisan number crunchers in Congress, ran the numbers on the Republican proposal. And they estimated that by 2019, it would have covered, wait for it, 3 million uninsured people. That`s compared to the Affordable Care Act`s 30-plus million.

So, that`s the graph you`re seeing here. The blue lines going up are the number of people covered under the Affordable Care Act. And those tiny red bars you see if you look down towards the bottom of the screen, the ones that don`t seem to move very much, it`s number of people covered by the Republican alternative.

So the Republican alternative would cover less than a tenth as many insured people as the president`s plan, and that Eric Cantor says is the GOP`s plan today, which is all to say McConnell was, as usual, right. The Republicans really don`t see covering the uninsured as, quote, "the issue". And they really are comfortable with the system in pretty much the form it exists today.

As I told you earlier, you should always listen to Mitch McConnell.

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