Healthcare: a conservative Waterloo

When President Obama passed his healthcare legislation on 22nd March, the American right suffered its most crushing legislative defeat since the 1960s. It’s hard to exaggerate the magnitude of the disaster. My fellow conservatives have since cheered themselves by suggesting Obama’s unpopular bill will deliver defeat in the November midterms. But with the economy improving, and the immediate goodies in the healthcare bill reaching voters by then, this seems over-optimistic. And even if they are right, so what? Legislative majorities come and go. This healthcare bill is forever. A win in November is poor compensation. A huge part of the blame for this attaches to ourselves. We conservatives made a strategic decision. Unlike the Democrats in 2001—some of whom supported President Bush’s first tax cut—we decided to make no deals. No negotiations, no compromise, nothing: we were going for all the marbles. This would be Obama’s Waterloo, just as healthcare was Clinton’s in 1994. But the hardliners overlooked a few vital facts. Obama was elected with 53 per cent of the vote, not Clinton’s 42 per cent. The liberal voting bloc in congress was bigger and stronger than in 1993-94. And the Democrats had learned from their own history—they remembered the consequences of their failure to pass healthcare under Clinton. So this time, when we went for all the marbles, we ended with none. Could a deal have been reached, swapping some Republican support for dropping the worst bits of the bill? Who knows. But the gap between the plan Obama passed and ideas long espoused by Republicans is not big. Indeed, the legislation has a broad resemblance to the reforms introduced by likely Republican presidential candidate Mitt Romney, when he was governor of Massachusetts. It also builds on ideas developed at the conservative Heritage Foundation in the early 1990s—ideas that formed the basis for Republican counter-proposals to Clinton’s plans in the mid-1990s. Obama badly wanted Republican votes for his plan, so it’s at least possible that the right could have won concessions: fewer taxes on productive private enterprise, less damage to small businesses, or a smaller expansion of the government’s Medicaid programme for the elderly. Too late now. No illusions please. This bill will not be overturned by the courts, or repealed. Even if Republicans win a landslide, few votes will be mustered to roll back the elements of the bill that most people like: healthcare for poorer children, or helping the elderly pay less for their prescription drugs. And how many would really vote to allow health insurance companies to rescind their policies if they discover a customer has a pre-existing medical condition? We followed the most radical voices in the Republican party, and they led us to abject and irreversible defeat. True, there were some who would have liked to do a deal. But they were trapped: Fox News and talk radio had whipped the Republican voting base into such a frenzy that deal-making was impossible. How do you negotiate with somebody who wants to murder your grandmother? Or, more exactly, with somebody whom your voters believe wants to murder their grandmother? I’ve been on a soapbox for months now about the harm this overheated talk inflicts. Yes, it mobilises supporters—but only with hysterical accusations and pseudo-information. It has made it impossible for representatives to represent, and elected politicians to lead. Our leaders are now the television and radio pundits, who have different imperatives from those who compete for office. Such thoughts triggered scathing personal comments against me on the editorial page of the Wall Street Journal just after the healthcare bill passed. And three days later, I was out of my job at the American Enterprise Institute, a conservative think tank where I had worked since 2003. No complaints here; there is no tenure at think tanks. But the question raised by this incident is one asked by a young libertarian blogger called Julian Sanchez: have US conservatives entered “epistemic closure,” isolating themselves not only from unwelcome opinions, but unwelcome facts? Many conservatives will go into the coming elections thinking that the passing of healthcare will translate into more Republican seats. Perhaps. But majorities come and go. The bill will endure. Conservative reforms will now have to be fought for, inch by bloody inch. For the cause America’s militant conservative pundits purport to represent, this has been a Waterloo all right: ours. This article is adapted from a post on www.frumforum.com