Talking Points Memo dug up a memo Bill Kristol wrote 20 years laying out how and, what I found more interesting, why, Republicans should oppose Bill Clinton's health care reform completely, no compromises, no making it better, offering no reforms except as talking points. This isn't just an historical document for the health care fight of 1993-94, nor is it significant merely because Republicans used the same no-compromise strategy to try to defeat Obamacare. It's significant for how it lays out why Republicans thought, and still think, the stakes are nothing less than the survival of conservatism.

Two things jump out: little mention of people with no access to the healthcare system (let unemployed people deduct the cost of health insurance without a word of how they pay for it with no income, and some regulatory fix for people with pre-existing conditions), and an assumption liberals don't care about health care, but just want to use it to expand big government and make the middle class dependent.

Any Republican urge to negotiate a "least bad" compromise with the Democrats, and thereby gain momentary public credit for helping the president "do something" about health care, should also be resisted. Passage of the Clinton health care plan, in any form, would guarantee and likely make permanent an unprecedented federal intrusion into and disruption of the American economy--and the establishment of the largest federal entitlement program since Social Security. Its success would signal a rebirth of centralized welfare-state policy at the very moment we have begun rolling back that idea in other areas.
But the Clinton proposal is also a serious political threat to the Republican Party. Republicans must therefore clearly understand the political strategy implicit in the Clinton plan--and then adopt an aggressive and uncompromising counterstrategy designed to delegitimize the proposal and defeat its partisan purpose.
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.
This is part of the big government/small government debate conservatives engage in, assuming our motives are the mirror image of theirs, when in fact we never have that debate on the left because we don't care. We want government to be big enough to do what we want it to do. So do conservatives, as it happens. They just want it to do different things, and to do those things, they'll make it as big as they have to. Really, among your liberal friends, ever had an esoteric discussion on how big government should be? For the conservatives looking in, ever have such a discussion with you starting it? Me neither.

The tragedy is Democrats tried so hard, both under Clinton and Obama, to take compromise positions that preserved the private health insurance industry despite the anguished screams of the Democratic base, and this compromise was impossible because Republicans can't compromise on it. They thought and still think giving in at all means giving up a future for conservatism.
Kristol does say Clinton's plan would be bad policy, repeating the usual tripe about the US having the best medical system in the world, yet like Republicans of the present day, his fear is the public will like the plan and conservative ideology will have been proven wrong. In other words, health care reform is doomed to fail, yet mysteriously if it happens, it will be popular. Having it work is worse than having it fail.

Republicans fought as hard against their own plan as they would have fought against single-payer, so what was gained by refusing to even bring up single-payer at a congressional hearing? Absolutely nothing. The error of congressional and presidential Democrats was the failure to understand their opponents, and to think, as Republicans did, that the opposition was engaging in the same thought process. No wonder Democrats thought the fight was about policy and fought it like the issue was how to solve problems and get everyone access to the health care system, while Republicans thought it was about which ideology would survive, and so they fought and still fight like the stakes are that high. It's "You're trying to destroy us" versus "We're trying to regulate the health insurance industry". Guess which side had more passion?

One more giveaway of conservative assumptions about liberals Kristol made: "If we can, in this way, provide a principled alternative to the paternalistic experimentalism that consistently underlies Democratic ideas of governance, Republicans will be poised to claim the moral high ground in this and future debates." So they're principled, and we're just engaging in paternalistic experimentalism. That's what conservatives think we're thinking with social programs. We're just rearranging the pieces to see what happens. We think food stamps is about people who can't afford enough food, and they think it's some experiment. We think unemployment insurance is about providing income for people who can't find work, and it seems not to occur to our opponents that fixing a problem has anything to do with it.

So when conservatives seem driven nuts by health care reform, and we're mystified they get so worked up about regulating the health insurance industry, it's because they don't believe us when we say it's about access to the health care system or addressing costs. That's the gist of all this: they believe it's an ideological attack, and if they don't stop Obama completely, conservatism loses forever. I'm skeptical of the notion that most people, wherever they are ideologically, have any idea what "ideology" means, or that they consciously think anything like "this attacks/supports my ideology". Kristol and his intended audience thinks that way, but we shouldn't assume most conservatives do. They do appear, however, to believe their traditions, culture, identity, and such similar words, are under attack. If someone starts with the presumption a policy is merely a means of ideological warfare, then it makes sense that the particulars of the policy don't matter to them.  Maybe if liberals felt under such an attack, we wouldn't care about the particulars either. There I go with the liberal nuance, but let' recognize that while recent years have been somewhat dislocating for everyone, it's been worse for conservatives. We've been frustrated when our ideas don't get tried, but they've been frustrated by seeing theirs tried and fail miserably. Whether they rationalized themselves into that position or spent too many hours credulously absorbing Fox News, there they are. We need to keep in mind that our opposition simply isn't coming at an issue, especially this issue, from a place similar to ours.

Originally posted to ericf on Fri Sep 27, 2013 at 03:15 PM PDT.

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