Why the GOP's mortifying health-care failure is great for America -- and Republicans

This is a quandary where two conservative priorities are put in tension. Conservatives want to deregulate health care. And conservatives want the government to spend less money on health care. The problem is that they can’t do both. If they repeal bad ObamaCare provisions (and they are bad), such as guaranteed issue (which forces insurers to provide coverage to anyone), or community rating (which prevents insurers to price based on the customer’s actual risk), many people will suddenly find coverage unaffordable. If these people don’t get money to compensate for those short-term fluctuations and keep getting covered, there will be millions of pissed-off Americans. By the same logic, if conservatives want the government to spend less money on health care, the only way to do it in the short term is through regulations that force insurers, and maybe providers, to provide services at essentially below cost, which means regulation. The AHCA tries to thread that needle by doing a little of both, but it won’t work. It won’t work politically, because it gives every stripe of conservative a reason to be angry; and it won’t work on the policy merits, because lots of people will lose coverage and because it won’t fundamentally inject consumer dynamics into the health-care system.

One of the deep and time-honored insights of conservatism is, quite simply, that you don’t always get everything you want, because the world is tough. Conservatives are going to have to choose. And they should choose the approach that gets rid of the regulations.