Strengthening Constitutional Self-Government

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Health Care

Health Care As A Generational Argument

National Review has a symposium on what to do in the wake of Obamacare.  I mostly agree with Tevi Troy's idea that Republicans should push for particular changes to the health care bill in the direction of tort reform and the liberalization of the health care market to allow the offering of low cost high deductible policies and connecting those policies to a relentless political operation that tries to sell the benefits of those policies to the public.  The changes won't happen in 2011, and they might not happen in 2013 or 2015, but if the public can be won over to such policies, the chances of moving away from Obamacare increase a lot.

The first instinct among many conservatives is to argue for a simple repeal of Obamacare.  That is what most conservatives want - even more than any particular reform.  Repeal also has the seeming advantage of uniting conservatives with nonconservatives who were happy (or at least not too unhappy) with the pre-Obamacare status quo.  The problem is that this alliance of conservatives and cautious nonconservatives will weaken with time if it is based on mere opposition to Obamacare.  No matter what happens in November, Obamacare will not be repealed for as long as Obama is President.  The veto pen will see to that.  The cautious nonconservatives will, over the next few years, get used to the new status quo.  Most Americans are happy with the quality of their medical care and that quality will not be change much or at all in the next few years.  Fears of government rationing are well founded, but it will take years and years of overpricing and overuse to get there.  Many of the cautious nonconservatives will become invested in the new system, and only a well argued positive alternative will get them to to take the risks of major change.  And soon enough, changing back o the pre-Obamacare status quo will be just as big a change as moving forward to a more free market-oriented alternative.

My great worry is that conservative passion about the health care and the public's attention to what conservatives have to say will be wasted in an unproductive cause that lets conservatives vent their spleen in the short term but leaves them with no real political or policy gains.  I look at the Sotomayor confirmation hearings.  Conservatives could have used them to highlight widely shared concerns about judicial liberalism related to issues like the Second Amendment, partial birth abortion, and the death penalty.  Sotomayor might have dodged, but the public would have heard conservatives on those issues and every time Sotomayor voted with the Supreme Court liberals on those kinds of issues, conservatives would have been in a stronger position to tie Obama and the Democrats in general to her positions.  Conservative instead wasted too much time and energy on the "wise Latina" crack.  It just felt too good to tweak liberals that one of their own had made such a slip, even though that attack didn't go anywhere (it was never going to sink her nomination and it is doubtful she will be some kind of racist Latino supremacist from the bench) and might have alienated some Latino voters. 

I suggest that the best course for conservatives (and that includes the Republican leadership, prospective 2012 Republican nominees, and the right of center pundit and popularizer community) is to start making the long term investment of explaining to the public the benefits of various conservative health care reforms.  Paul Ryan, the think tankers, and the people at National Affairs can't do it all by themselves. 

 

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