If GOP Won't Deal, Health Law Won't Change
I'm going to get personal here. On the day that health care reform passed its final vote in the House, I posted on my blog a comment titled "Waterloo."
I said that the intransigence of Republican leaders had thrown away opportunities to negotiate improvements in the health bill -- and that Republicans now needed to hold accountable those leaders who led conservatism to this utter defeat.
This is what I wrote: "At the beginning of this process we made a strategic decision: unlike, say, Democrats in 2001, when President Bush proposed his first tax cut, we would make no deal with the administration. No negotiations, no compromise, nothing. We were going for all the marbles. This would be Obama's Waterloo -- just as health care was Clinton's in 1994.
"Only, the hardliners overlooked a few key facts: Obama was elected with 53 percent of the vote, not Clinton's 42 percent. The liberal block within the Democratic congressional caucus is bigger and stronger than it was in 1993-94. And of course, the Democrats also remember their history, and also remember the consequences of their 1994 failure.
This time, when we went for all the marbles, we ended with none."
That column cost me my job at a Washington think tank. And now, as Republicans celebrate their biggest congressional victory since 1946, I am getting a lot of e-mail that taunts me: "See how wrong you were?"
To which I say: Enjoy the moment, fellas. You are only at the beginning of the pain of discovering how right I was.
From a conservative point of view, there's a lot not to like about the Democratic health care reform.
I don't like the new taxes to pay for it: a new tax on payrolls and a new tax on investment income. I don't like the new burden on the states, in the form of higher Medicaid spending. I don't like the plan's steps toward price controls instead of price competition.
I could go on.
But all those things I don't like -- they are all the law of the land. To correct them will require action by the House, Senate, and president.
That's tough at any time, tougher when Republicans announce that they have no intention to compromise on anything. No compromise means no deals.
So instead, Republicans will fall back upon a Plan B, basically a series of stunts.
They'll schedule a vote to repeal the "cuts" in Medicare under health care reform. (Not really cuts -- restrictions on future growth.)
They'll refuse to appropriate funds to implement aspects of health care reform.
They'll call hearings to publicize problems with the law and complaints from those negatively affected.
And at the end of two years, the law will still be there, more or less intact.
Repealing the Medicare "cuts" won't repeal the health care plan. Repealing Medicare cuts will only add to health care reform's costs without altering reform's basic shape.
Some Republicans advocate "defunding" -- refusing to appropriate the money necessary to get reform operating. And yes, you can certainly imagine that Republicans might refuse to fund the new agencies created by health care reform. But will Republicans refuse to fund -- for example -- the huge expansion of prescription drug coverage for seniors? I'll believe that when I see it. More likely, the Republicans will harry, vex, and annoy the Obama administration -- but leave the main elements of the Democratic plan to trundle forward.
Hearings to publicize the glitches in health care reform will surely happen. And some of the problems brought to light will be very serious. But of course the seriousness of those problems only underscores the question: Why not work harder to avert those problems when there was still time? Why not act now to fix those problems before health care reform goes fully into effect?
But if there is no compromise, there can be no negotiations. And if there are no negotiations, there can be no fixes -- because every important fix requires the concurrence of the Senate and the president.
Republican leaders know that. They know that their strategy for the next two years will not fix health care reform, nor much change it. The Republican leader in the Senate, Mitch McConnell, acknowledged so much in a speech last week to the Heritage Foundation:
"We may not be able to bring about straight repeal in the next two years, and we may not win every vote against targeted provisions, even though we should have bipartisan support for some. But we can compel administration officials to attempt to defend this indefensible health spending bill and other costly, government-driven measures ..."
Compel the administration to defend. McConnell outlines a strategy for doing what political professionals would call drawing a contrast. It's a strategy that has as its immediate goal winning the next election, not improving the bill.
McConnell might say: "The only way we get change is by electing more Republicans." But that's quite a risky route. Not only does his route imply that we must elect a Republican president in 2012, but that we must elect more than 60 Republican senators -- because so many of the changes Republicans want can be filibustered. It's not very likely to happen. McConnell's strategy points us to a future where Republicans use the Obama health care reform to raise funds and win elections -- but where health care itself remains substantially intact.
Surely anybody who was serious about fixing Obama-care would want a more certain plan? Something that can assure Americans today that the worst elements of the plan are likely to be improved and soon?
As is, we're getting a bad trade: Republicans may gain political benefit, but Democrats get the policy. In this exchange, it is the Democrats who gain the better end of the deal. Congressional majorities come and go. Entitlement programs last forever.
That was my warning in March 2010. This election does not discredit that warning. It confirms the warning.
Originally published at CNN.com.