Our brilliant commenter Carl Scott (who should be hired for some full time pundit gig at a major newspaper or magazine) rightly pointed out in one of the threads that if Obamacare passes, "Repeal It" will be the phrase of the day, month and maybe years on the right. This sentiment might help drive turnout among right-leaning people who consume conservative media, and it might help win some close House and Senate seats. But I think that "Repeal It" sentiment will prove to be a wasting asset if it is not supplemented with an-almost-as-great focus on alternative conservative policies. People are risk averse on health care. That is one of the great advantages that conservatives have enjoyed in the argument over Obamacare.
The problem is that the moment Obamacare passes, that advantage begins to flip in favor of Obamacare. Repealing guaranteed issue might seem like a net loss. Some of the medicare cuts can be repealed. Whats an extra couple of hundred billion between friends? We'll take care of it with an... uh freeze...starting in a couple of years. If premiums rise faster than expected, the blame can be shfted to the mean old insurace companies. Not only are they raising your premiums, if we repeal Obamacare, they will take away your insurance. There will be no alternative to patiently explaining the policy problems of Obamacare and pitching the message to the median (and even Democrat-leaning but persuadable) voter rather than commited and inflamed conservatives. The problem is that it will be tough to sell them on the benefits pre-Obamacare status quo, not because Obamacare will be good, but because, in the short and medium term, the practical difference between Obamacare and pre-Obamacare will be so small. One would give up security and get in return the pre-Obamacare rate of increase in premiums. But that rate was already too high, so it might not seem like such a big benefit. I can see Obamacare being replaced by a conservative policy alternative that promised lower cost and equal or better quality, but I can't see it simply repealed.
Replacing Obamacare with a free market-oriented alternative will involve huge expenditures of time and energy in explaining the policies and benefits to the public and defending them from what are sure to be furious and well funded liberal attacks. Conservatives are already years behind in the task of selling the public on free market-oriented alternatives to the status quo. In the wake of Hillarycare's defeat, the dominant consevative message on health care was 1) greatest health cares system in the world 2) no socialized medicine 3) something about tort reform. McCain had a health reform plan he could not bother to defend from Obama's attacks. Perhaps he thought responding would take attention away from more important issues like earmarks and whether Obama had compared Sarah Palin to a pig. Both of these approaches probably seemed like the easy way at the time. Explaining how a combination of HSA's and catastrophic coverage (or moving to a system of individually bought insurance through tax code changes) will help bring down costs without hurting the availability of crucial services is tough. Explaining the policies to help people with preexisting conditions during the transition to such a system will be painstaking because people will be scared, the ideas will be new to them, and the Democrats will be trying to terrify them. If conservatives have a rhetoric for explaining these approaches to people who aren't CSPAN junkies, I haven't heard it.
Focusing on "Repeal It" will likewise seem easy. Right-leaning America will have those words on their lips (and as Carl said, bumber stickers too). It won't mean having to do the hard jobs of settling on alternative reform policies, developing ways of explaining them and having the sheer energy and persistence it will take to defend them in the face of what are sure to be relentless attacks. But avoiding the hard jobs is one of the reasons why we are on the edge of state-run health care.