Health-Care Reform Could Kill the GOP

Can policy be both wise and aggressively partisan? Ask any Republican worth his salt and the answer will be an unequivocal yes. Ask a Democrat of the respectable Beltway variety and he will twist himself into a pretzel denying it.

For decades Republicans have made policy with a higher purpose in mind: to solidify the GOP base or to damage the institutions and movements aligned with the other side. One of their fondest slogans is "Defund the Left," and under that banner they have attacked labor unions and trial lawyers and tried to sever the links between the lobbying industry and the Democratic Party. Consider as well their long-cherished dreams of privatizing Social Security, which would make Wall Street, instead of Washington, the protector of our beloved seniors. Or their larger effort to demonstrate, by means of egregious misrule, that government is incapable of delivering the most basic services.

That these were all disastrous policies made no difference: The goal was to use state power to achieve lasting victory for the ideas of the right.

On the other side of the political fence, strategic moves of this kind are fairly rare. Instead, for most of my lifetime, prominent Democratic leaders have been chucking liberalism itself for the sake of immediate tactical gain.

Former President Bill Clinton, who is widely regarded as a political mastermind, may have sounded like a traditional liberal at the beginning of his term in office. But what ultimately defined his presidency was his amazing pliability on matters of principle. His most memorable innovation was "triangulating" between his own party and the right, his most famous speech declared and end to "the era of big government," his most consequential policy move was to cement the consensus on deregulation and free trade, and many of his boldest stands were taken against his own party.

The results were not pretty, either for the Democrats or for the nation.

Still, conservatives have always dreaded the day that Democrats discover (or rediscover) that there is a happy political synergy between delivering liberal economic reforms and building the liberal movement. The classic statement of this fear is a famous memo that Bill Kristol wrote in 1993, when he had just started out as a political strategist and the Clinton administration was preparing to propose some version of national health care.

"The plan should not be amended; it should be erased," Mr. Kristol advised the GOP. And not merely because Mr. Clinton's scheme was (in Mr. Kristol's view) bad policy, but because "it will revive the reputation of the party that spends and regulates, the Democrats, as the generous protector of middle-class interests."

Historian Rick Perlstein suggests that this memo is "the skeleton key to understanding modern American politics" because it opens up a fundamental conservative anxiety: "If the Democrats succeed in redistributing economic power, we're screwed."

In the Clinton years, of course, it was the Republicans who succeeded. And the Democrats' failure -- the failure to deliver national health care that is, not the act of proposing national health care -- was a crucial element, in Mr. Perlstein's view, in the Republican Revolution of 1994. Assessing the accomplishments of the "party of the people" after those first months of Clintonism, middle-class Americans were left with what? A big helping of Nafta. Mmm-mmm.

Fourteen years later, we find ourselves at the same point in the political debate, with a Democratic president-elect promising to deliver some variety of health-care reform. And, like a cuckoo emerging from a clock, Mr. Kristol's old refrain is promptly taken up by a new chorus. "Blocking Obama's Health Plan Is Key to the GOP's Survival," proclaims the headline of a November blog post by Michael F. Cannon, the libertarian Cato Institute's director of Health Policy Studies. His argument, stitched together from other blog posts, is pretty much the same as Mr. Kristol's in 1993. Any kind of national medical program would be so powerfully attractive to working-class voters that it would shift the tectonic plates of the nation's politics. Therefore, such a program must be stopped.

Liberal that I am, I support health-care reform on its merits alone. My liberal blood boils, for example, when I read that half of the personal bankruptcies in this country are brought on, in part, by medical expenses. And my liberal soul is soothed to find that an enormous majority of my fellow citizens agree, in general terms, with my views on this subject.

But it pleases me even more to think that the conservatives' nightmare of permanent defeat might come true simply if Democrats do the right thing. No, health-care reform isn't as strategically diabolical as, say, the K Street Project. It involves only the most straightforward politics: good government stepping in to heal an ancient, festering wound. But if by doing this Barack Obama also happens to nullify decades of conservative propaganda, so much the better for all of us.

Thomas Frank's column, The Tilting Yard, appears every Wednesday at OpinionJournal.com

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Comments

[mayzebra]

I wish....

As long as we have the brain dead TV viewers, we will have conservatives spoon feeding them propaganda... People have been convinced through propaganda that Canadians and French are unhappy with their healthcare, when, in fact, even Lebanon has a better healthcare system than ours.

We will simply not have decent healthcare for the middle class until we have an option that doesnt involve health insurance companies... they just dont pay! Most of those people filing bancrupty had insurance; they thought they were covered.. they were not. So people are reduced to working part time or not at all so their children can qualify for medicaid. I know; I'm one of them.

[jinxed]

To me, any company that makes money off the backs of the sick and injured is immoral and unethical. This is what the Republican Party stands by. We need a health care system that is single payer and covers all. If that means an end to Blue Cross/Blue Shield and companies of that ilk, so be it! They (health insurance companies) can go the way of Lehman Brothers.

[Overd0g]

For a 36-year old male living in my area, there were 119 quotes through eHealthInsurance with monthly premiums ranging from a low of $37 per month ($10,000 deductible, co-insurance of 20%) to a high of $232 per month ($0 deductible, 0% coinsurance), and there were 62 different plans with premiums of $100 per month of less. For a 36-year old female, the premiums are slightly higher, ranging from $47 to $307 per month.

[Overd0g]

The GOP and America could go down together.

[Dknow]

Europeans have been doing this for decades and you don't see any of them clamoring to have an American-style health care system.

When I was a poor, travelling student , winter camping in the mountains during the '76 Olympics, I came down with strepthroat. Without speaking German, I was able to make my way to a doctor's office on the streets of Innsbruck. He diagnosed my problem and directed me to his front office, with a prescription, which was immediately filled. When I tried to pay for their services and the woman behind the desk appeared stunned. "You don't have to pay, we [Austrians] help everyone who needs it."

After suffering through two terrible World Wars, the Europeans, with our help, rebuilt their countries to serve their countrymen. They had an incredible opportunity for a "do-over". Their railroads and public transportation are another example of taking the opportunity to "do it right."

America now has an opportunity to "do it right", even if we don't know what "it" will be. It is not only greed that has crippled our progress, it is the lack of ethics that greed breeds. If we act with ethics and integrity, we will do "right". If this leads to the death of the GOP it is because they have acted without ethics and integrity.

[PATina]

On the other side of the political fence, strategic moves of this kind are fairly rare. Instead, for most of my lifetime, prominent Democratic leaders have been chucking liberalism itself for the sake of immediate tactical gain.


And it looks as if they are about to do it again. Personally, I don't think universal health care will kill the GOP (especially not the plans that still keep the insurance companies involved).

[Mrjonz]

If America were truly the Christian Nation that Republicans and their followers keep insisting it is, something like national health care would not be debated, it would be mandated. Who would Jesus deny food, shelter, or comfort from pain and disease?

[yappnmutt]

i agree with the need for health care reform. let me get that straight first.

i believe the republicans had a plan to rule forever, too. see how that turning out?

[btanner]

I'm keeping my fingers crossed on this one. Millions of Americans are skipping on their medications or refuse to see their doctors because they cannot afford to, thus risking their health even further. Access to affordable medical care is a basic right and should not be a consequence of your employment.

[appleknocker]

Refresh my memory, please: When was the last time either party did "the right thing?"

[bkbigfish]

Yes, please try to push universal health care in the midst of this huge recession. Any idea how much that would cost? And please don't come back with the talking points number. Enormous as that is, the true cost would undoubtedly be far higher, as it was with the presciption drug benefit, and pretty much everything else the Gov lays it's hands on. Oh, but what do the poor care? They don't pay any taxes anyway, so they could care less about the tax burdens on the people in this country who actually create jobs.

[Egalitare]

"Those people who actually create jobs" have not been doing so for decades.

[rkg2004]

You just proved the blogger's point. Same old tired talking points. YAAWWWNNNNN

[porcolino]

if the government can cough up billions to secure the health of the banking sector, billions for life support measures for the car industry, billions for the survival of its Iraq policies, it should by all means be able to assure the basic health of those who elected it, the people.

[appleknocker]

It can only cost money by putting more people (i.e. health care providers) to work. That's what needs to be done in a recession. Read your Keynes.

[Miles J. Zaremski - Huffpost Blogger]

Three cheers here. If one were to look at the history of how Medicare came about 43 years ago, (s)he would see that then President Johnson used his know-how and political muscle to advance this piece of social legislation into law (7-30-65). This was brought out in recently released audio and archival materials. And, as is pointed out in this post, so too, back in 1965, the Republicans were acting like curmudgeons, using as much bluster as they could muster to defeat health care for seniors back then. Obama's mantra is for change; with health care, that change means health care no longer for those we refer to as our senior population.

[Bardmess]

Health care should not be for profit and everyone should have it. While we're at it, let's also subsidize education for health care professionals. They shouldn't be borrowing money for med school, etc. Neither should doctors expect to become millionaires. As for the current parasitic health insurance for profit industry, let's make it go away, completely, forever. Then we can really sing..."ding-dong the witch is dead, the wicked witch is dead....horray!"

[MADJon]

This is an important point. Limited and expensive education for doctors, nurses and other health care providers restricts the availability of service and keeps it expensive by holding back supply.
We should subsidize training in exchange for a term of service, which could include relocation to areas of need. This would manage cost and provide service in urban and rural areas that wealth-hungry practitioners currently avoid. The subsidies could also direct students to general practice or non-popular but needed specialties.
This would be, in effect, a National Medical Corps; not unlike the regular Army or National Guard. No one complains about the socialized military. In fact, we tout its excellence and world superiority. Why do some assume a National Medical Corps could not be outstanding as well?

[PoorManRichMan2009]

I see lots of posters here talk about the pros and cons of Universal Health Care as if the govt is going to foot the bill.

Let me enlighten you ONE MORE TIME!!

Not all of European countries are socialized medicine.

We here in Holland switched to all PRIVATE 3 years ago. However, we killed 2 birds with one stone.

First off, its MANDATORY that anyone in the country MUST have a health insurance policy. There are about 15 companies in our small country of 16 million that provide those policies. The law states they MUST insure anyone (no prescreens, pre existing conditions etc).

The average cost is 100 Euros per person, no limitations , in fact, its a FELONY to ask for prescreens.

The secondary benefit is that is has put quite a screeching halt to illegal immigration.

IN order to buy the policy, you must show 3 forms of ID, passport or legal permanent residency status.

This way everyone is insured.

It seems to be working quite well, and I have never had to wait for anything .

If for some reason you have to go on unemployment, the premiums are deducted from your money and sent to the insurer BEFORE you get it.

Is that so hard to understand??

I know many of you think that is socialism but the govt HAS to monitor greedy companies from gouging people.

[yappnmutt]

yea, but your gov't is backwards. don't you know gov't is suppose to represent the money and not the people?

[kimleehan]

Question, Would you donate your time and resources to a organization or cause that if you were ever in need of its service would deny you their services?
23% of organ donors who made their organs available for transplantation upon their death were uninsured and probibly that many more were underinsured.
If you are uninsured or underinsured and without the ability to pay, than you are no longer a good candidate for transplant surgery but and I repeate but you are eligable to donate your organs in the event of your death.The reason being federal law says that a potential recipient must show the ability to pay for the transplant before they can be placed onto the United network of organ sharing's national wait list. and not being placed on that list is almost certain death.
So if you want universal health care don't put your name on that list.