Monday, July 2, 2012

Conservatves Never Wanted Health Care Reform

The collective conservative/Republican conniption over the US Supreme Court's ratification of most of the Affordable Care Act has brought a fresh round of confused liberals eager to remind everyone that "Obamacare" is essentially the same as "Romneycare" (enacted by Governor Romney in 2006) and that plan was itself based on a plan devised by the very conservative Heritage foundation back in 1994. 

That's fine, I'm all for reminding people that this ridiculous tantrum is not only hypocritical but completely fake on the part of the movement's leaders who used to be all for mandates before they declared conservatives have always been at war with East-Asia some time in 2009.  That said, what's happening here is not so much that they're just mad Obama stole their idea and don't want him to get credit for bi-partisan centrism in implementing the right's own health care reform proposal, what it really says to me is that they were never serious about those proposals.  They needed a health care plan in the 90s to counter Clinton's proposals, but never had any real intention of implementing such a thing.  It all goes back to the infamous Bill Kristol strategy memo from 1993, on how and why to defeat Health Care reform entirely:
But the long-term political effects of a successful Clinton health care bill will be even worse--much worse. It will relegitimize middle-class dependence for "security" on government spending and regulation. It will revive the reputation of the party that spends and regulates, the Democrats, as the generous protector of middle-class interests. And it will at the same time strike a punishing blow against Republican claims to defend the middle class by restraining government.
It's just not in their interests politically.  They've set themselves up to win power on a certain critique of government, and solving the health care coverage crisis completely undercuts that.  Kristol specifies the Clinton health care bill, but I don't see the logic being much different for any bill that ends up with universal or near universal health coverage. 

It's hardly theoretical either.  We can't know whether Dole would have actually tried to implement a version of the Heritage '94 plan if he had won in '96 (with Dole there's reason to think he may have been sincere about wanting to expand health coverage, but even so I'm really skeptical the rest of the Republican/movement Conservative establishment would have gone along) but we can skip ahead to 2000, where we have Gore with some serious proposals to greatly increase coverage (though he shied away from running on UHC), and Bush who waved his hands at various tax cuts and tax credits that might marginally help a few people but would in no way address America's health care coverage crisis.  Then of course Bush took office, and despite having a Republican run Congress for most of his Presidency and plenty of Democrats fully willing to play ball on expanding health care coverage, somehow never got around to Health Care Reform.  If you recall, the 2001 tax cuts were partly premised on Fed Chair Greenspan's warnings that the US debt might get paid off too quickly, well that sounds like a fantastic opportunity to putting some of that surplus into funding health care for the uninsured, but instead it all had to go to tax cuts.

I read some of the most ardent left wing critics of the ACA, like Ian Welsh and I certainly can't dismiss the things they say will go wrong with the plan (like the possibility of Insurance companies just jacking up rates to consume the subsidies) but to the extent I can maintain hope it will be better than the status quo, the ongoing right wing freak out over it makes me think it has a good shot of doing so.  It's costing the right a lot to abandon their own idea and in particular having to cover for Mitt Romney who was in favour of such ideas as late as 2007 can't be part of some long term plan.  Yes, they can usually paper over whatever flip flops or hypocrisy they want to in their stars, but Palin proved there's a limit to their powers of media manipulation in a campaign.  Romney's reputation for flip-flops, inconsistency and so forth is approaching Palin levels of absurd.  It's costing them to deal with this (even if rank and file conservative authoritarians have no problem with the cognitive dissonance, they need another 20-30% of the population to win the election), and I have a hard time believing they're secretly thrilled about the ACA but staging a multi-year fit of apoplexy against it just to sweep in 2012 and then somehow fail to repeal it.  I'll eat my words if I'm proved wrong, but all I see is a plan they proposed back when the American people demanded they have a plan, one they intended to ignore when in office, as they did under Bush.  Whatever local circumstances led Romney to support health reform in Massachusetts aren't replicated nationally. 

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