A couple interesting health care news stories today. First, the GOP has absolutely no idea what to "replace" the Affordable Care Act with:

Republicans are promising to repeal and replace President Barack Obama's health care overhaul if they win control of Congress. But with what?

Not even they know.

Some have proposed major changes to workplace coverage, even turning Medicare into a voucher plan. Many prefer small steps that tiptoe around political land mines. Others want a clean start. ...

For now, it looks like Republicans are pushing hard on the repeal part of their slogan, but treading gingerly when it comes to replacing.

"There's only one (idea) I can give you for certain, and that's medical malpractice reform," said Sen. Chuck Grassley, R-Iowa, a leader on health care. "The rest is pretty much dependent on what the election does."

Aside from placing limits on jury awards in malpractice cases, two other ideas seem to have consensus support among Republicans: strengthening the prohibition against the use of federal funds to pay for abortions, and flyspeck oversight of the Obama administration's efforts to implement the health care law.

Remember, unlike 1994, Republicans could not afford to defend the health care status quo in 2010. The public demanded health care reform, and Republicans took the position that they favored some superior alternative proposal that would do all the good stuff and none of the bad stuff. Actually formulating a plan that satisfies those requirements is impossible.

So what do they plan to do instead? Throw sand in the gears:

Republican congressional aides and advisers say their focus would including blocking funding to hire new Internal Revenue Service agents, who are needed to enforce the law's tax increases. They also would consider barring spending for a new board that approves Medicare payment cuts as well as on research that compares the effectiveness of medical procedures.

Other potential targets include funds to pay for a long-term care insurance program and money to help states set up insurance exchanges where consumers will be able to use tax credits beginning in 2014.

This plan, while totally immoral, seems like the shrewdest approach. If they can make the health care law fail by sabotaging its implemetation, the public is going to hold President Obama responsible for the results, and Republicans will benefit politically.

I continue to be amazed that the Republican position is total oppositon to a board approving Medicare payment cuts and to research comparing the effectiveness of different procedures, thereby trimming away waste in the Medicare system. You can, I suppose, make a case that medical care is so important that we cannot allow a process to cut out even totally wasteful procedures -- interventions that do nothing to improve patient health -- for fear that this would somehow, some way, lead to rationing of needed care. But could anybody have imagined that the conservative party is the party making this argument?