Wednesday, September 23, 2009

Long term vs. Short term cost-benefit in opposing Healthcare reform

Jonathan Chait wonders whether a focus on winning the battle on Healthcare Reform will lose the war for Republicans:
Republicans are acting in their individual and collective political self-interest. Individually, Republicans realize that their base is convinced that Obamacare equals socialism plus death panels, and thus any Republican who signs on would kiss away his political future and quite likely face a primary challenge. Collectively, the party has put all its chips on defeating health care reform, or, as a fallback, withholding support and rendering reform a "partisan" exercise that can be used against red state Democrats in 2010.

It's a smart political strategy. But the health care plan that Obama signs is going to be around for a very lon time. Republicans might one day come to wonder if picking up some seats in 2010 were worth forgoing a chance to help put their imprint on the U.S. health care system.

If the issue was substance and not politics, I would 100% agree with this... if Republicans played ball with Baucus they could have gotten an even more conservative bill than is currently being debated in the Finance Committee, but their intransigence appears likely to push it leftward as Baucus shores up his flank. Assuming it passes, I would bet there will be some conservative thinkers regretting the missed opportunity down the line (though they got tons of concessions without having to support it, so it's still not even that bad of a deal).

On the politics, however, I just can't see the long term cost. After all, one of the tropes that gets trotted out by conservatives to object to reform is that "Social Security was bipartisan! Medicare was bipartisan! So you can't do Healthcare without Republicans!" But who really thinks of those two programs as "bipartisan"? Aren't they both identified with the party in power, and more specifically the President in office, when they passed? As far as history looking backward, this is Obama's bill for better or worse... and I don't see much to be gained for Republicans by voting for it. The only exception would be GOP Senators or Reps in Blue States, but pretty much all of those are gone now except for the lovely ladies from Maine (and I wouldn't be surprised to see both vote for it). Frankly, the current bills under consideration are all too incrementalist and technocratic to cause a massive shift that leaves Republicans wandering in the wilderness for 40 years. However, it seems clear that salient issue to come from reform is going to be controlling costs and lessening the burden of insurance on the middle class, and that is going to be a big issue for voters for years to come... but I don't see a vote now tying anyone to a position that won't be relevant until/if Obama gets reelected.

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