The Obama plan has a broad family resemblance to Mitt Romney’s Massachusetts plan. It builds on ideas developed at the Heritage Foundation in the early 1990s that formed the basis for Republican counter-proposals to Clintoncare in 1993-1994.
Barack Obama badly wanted Republican votes for his plan. Could we have leveraged his desire to align the plan more closely with conservative views? To finance it without redistributive taxes on productive enterprise – without weighing so heavily on small business – without expanding Medicaid? Too late now. They are all the law.
No illusions please: This bill will not be repealed. Even if Republicans scored a 1994 style landslide in November, how many votes could we muster to re-open the “doughnut hole” and charge seniors more for prescription drugs? How many votes to re-allow insurers to rescind policies when they discover a pre-existing condition? How many votes to banish 25 year olds from their parents’ insurance coverage? And even if the votes were there – would President Obama sign such a repeal?
We followed the most radical voices in the party and the movement, and they led us to abject and irreversible defeat.
There were leaders who knew better, who would have liked to deal. But they were trapped. Conservative talkers on Fox and talk radio had whipped the Republican voting base into such a frenzy that deal-making was rendered impossible. How do you negotiate with somebody who wants to murder your grandmother? Or – more exactly – with somebody whom your voters have been persuaded to believe wants to murder their grandmother?
It’s a little sad to note that what now passes for a responsible conservative thinks that the bill would be improved by being easier on the rich and not so helpful to the poor. But the underlying analysis is correct: Obama chose to pursue health care reform in rather conservative-friendly ways, and had the hand of friendship rudely slapped aside. Amost all right-wing discourse about health care reform so far has consisted of denying that simple truth.
It would be as foolish for any conservative or Republican to take political advice from me as it would have been for Democrats to take political advice from Newt Gingrich or Mitch McConnell. But David Frum has conservative Republican chops. Perhaps his advice deserves to be listened to.