Why will Republicans in D.C. do everything in their power to stop health care reform? Hint: It’s about politics, not policy

I just laid my hands on a revealing memo on President Obama’s current effort to reform health care. It was written just a few months ago by a senior, very influential conservative operative. He calls on Republicans in D.C. to go to the mattresses to stop Obama’s health care reform ideas. Why? Not because health care reform, as proposed by the Democrats, will turn out to be a disaster, or unpopular with the American people. Just the opposite: Republicans need to stop health care reform because it will succeed, and in the long run will re-cement the allegiance of the middle class to the Democratic Party.

Here are some excerpts from what this influential conservative wrote (I have taken the liberty of bolding the most important lines):
“The president will lobby intensively for his plan. It will surely be the central theme of his State of the Union Address in January. Health care reform remains popular in principle. And the Democratic Party has the votes...

“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 Obama 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 Obama proposal is also a serious political threat to the Republican Party. Republicans must therefore clearly understand the political strategy implicit in the Obama plan--and then adopt an aggressive and uncompromising counterstrategy designed to delegitimize the proposal and defeat its partisan purpose…

“If an Obama health care plan succeeds without principled Republican opposition… its passage in the short run will do nothing to hurt (and everything to help) Democratic electoral prospects in 2012. But the long-term political effects of a successful Obama 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 revealing stuff: We better stop health care reform because, if the Democrats pass it, the middle class is going to like it, and our anti-government ideology will be discredited. I couldn’t agree more.

Okay, now that you’ve read the above, I have to confess to a lie. The above excerpt is authentic, except for the fact that I have changed the word “Clinton” to “Obama” and “1996” to “2012.”The excerpts above come from a famous – perhaps infamous – call to arms written by conservative operative Bill Kristol in 1993 when Bill and Hillary were pushing their failed effort to reform health care.



Kristol is now the editor of the Weekly Standard and a Fox News talking head; back then, fresh off a stint as Vice President Dan Quayle’s chief of staff, Kristol was chairing something called the Project for the Republican Future.

But Kristol’s central insight about the threat to Republicans—and the obvious benefit to Democrats—of a successful health care reform measure is as relevant today as it was in 1993. If Obama and the Democrats succeed in passing a reform bill that addresses many of the flaws in our current health care system, it will result in a lasting political victory for the Democratic party as important as FDR’s creation of the modern American safety net during the New Deal.

In recent months, Republicans seemingly never tire of pointing out that the public opposes the Democrats’ health care reform bills as creeping socialism, a government takeover of health care. Still, recent polling shows they are right that voters reject the Democratic approach to health care reform—until you ask voters what they think about the key components of the bill.

It turns out—is this really a surprise?—that closing the doughnut hole for seniors’ prescription coverage or barring insurance companies from discriminating based on pre-existing conditions, or all of the other key elements of Democratic reform proposals, are very popular with voters. The low overall poll numbers for health care reform are more an indication of public frustration with the deals, the concessions to powerful lobbies, the endless partisan bickering, and the messy, drawn out legislative give and take compromises on popular ideas (public option),  rather than an indication that the voters (beyond noisy Tea Party types) see the core elements of health care reform as an unwanted "socialism."

Yes, health care reform has been watered down. Yes, the public is anxious about it and mistrustful that politicians in Washington, D.C. can deliver a package of reforms that will actually improve their lives. But the key policy changes that remain on the table as part of the Democratic health care reform agenda are a huge improvement on the system we have now. If  implemented—30 million uninsured people in this country will have insurance. Health care will be more affordable for millions more working and middle-income families. The power of insurance companies to jerk people around will be curtailed. And costs will be reduced. David Cutler, a Harvard economics professor who was Obama’s senior health care policy adviser during the 2008 campaign, calculates that the reforms proposed by Obama will save $600 billion over the next decade and more after that. Is it any wonder that Republicans would be terrified of the prospect of Democrats passing something like that?

Whatever happens in the November elections, in the long run, passing health care reform will be a huge political win for the Democrats. As the shock of the Massachusetts Senate loss wears off, Obama and key leaders in Congress finally appear to have figured it out. They have decided to do what they should have done months ago—pass a bill through the Senate via the reconciliation process, which will only require simple majority. The president is pushing hard to pass a final bill in the next 10 days, and Democrats in Congress are saying they are going to run this November on fixing the health care system.

Good. All of this sudden momentum seems to be sowing near panic in Republican and conservative circles. In the best sign yet that the Obama plan represents real reform that will benefit middle class consumers, the insurance industry is teaming up with right-wing business lobbies like the U.S. Chamber of Commerce and the National Association of Manufacturers to launch a $10 million television ad campaign in a final assault to block passage of a reform bill. Echoing the Republican mantra, they are calling on Congress to “start over” with health care reform.

If the big lobbies that benefit from maintaining the status quo are spending that kind of money, Obama must be doing something right. But while things are looking up, there are still serious hurdles to overcome. Pro-life House Democrats, who want the more restrictive Stupak amendment and not the Nelson amendment (and some members on the far left who are mad about the missing public option) are threatening to vote against reform. Final passage in either the House or the Senate is not yet secure. But if Congressional Democrats fail to follow Obama’s lead and pass reform now, they will only have themselves to blame for their defeat in November. And they will have missed a historic opportunity to bring real change that benefits millions of Americans and to prove they are willing fight for the working families and the middle class against entrenched, powerful interests.

Not coincidentally, the political dividends for such a far-reaching accomplishment could last a generation or more. Don't take my word for it. Just ask Bill Kristol.