America has just reached the end of a 14-month debate over whether or not and, if so, how to reform our health care system. The legislation with which we've emerged is a big tapestry of ideas, many of which are historically Republican ideas and many of which are Democratic ideas. The president said, "This isn't radical reform, but it is major reform." He's right. It's not radical because we will still have a predominantly employer-based insurance system. It's not radical because for-profit insurance companies will continue to be the major players on the scene. But it's major reform because through a series of tweaks to the system (subsidizing insurance purchases for the poor, expanding Medicaid, creating a national insurance exchange, reining in the worst industry practices, etc) we will end up insuring virtually every American. And according to the most objective referee we have for stuff like this, the CBO, we will make these "tweaks" while also reducing the budget deficit and reducing the tax and premium burden on working families. In other words, having everyone insured is going to be cheaper for America than having millions uninsured.
Sounds great. So why did this debate feel like nuclear war? Why did every single Republican member of Congress vote against this bill? What were conservatives standing up for by opposing the bill?
The Usual Suspects Of Anti-Progress
We would expect the small class of people who own and manage big health care companies--and big companies in general--to oppose the bill. They're looking out for their own personal interests and defending their positions of power. If anything is consistent throughout our political history, it is that this class exists and it intelligently defends its interests.
We would also expect racists and social conservative extremists to oppose the bill. They would view the legislation as too big of an equalizing force in society. They would not want to see people of other colors, religions, or sexual orientation gain any more solid footing and security in America.
OK, so that explains the CEO and KKK vote. But even I don't think the Republican coalition is just the corporate class and the hateful class.
The "Silent Majority" Of The GOP
How do we explain the raging opposition to health care reform from good-hearted, principled conservatives--conservatives like many of my friends and extended family? Sometimes in the heat of battle I have to remind myself that these conservatives exist. Decent and wise people have good reasons to argue for less government intervention in our lives, more local control, more emphasis on markets for distributing resources and making decisions. There is a principled conservatism out there, and there is an important place for it in our political dialogue.
But how does that principled conservatism translate into opposing health reform that saves lives and saves money--especially when there isn't a conservative path to universal health care on offer? What, other than abstract principles, are these conservatives losing with this reform? It's as though you told them, "I'll give you each $500 if you will let me save that person's life over there," and they chanted back in unison, "KILL THE BILL! KILL THE BILL!" (Actually, that seems like a pretty accurate summary of the whole health care saga of the last year.)
I understand conservative principles. I understand how comprehensive health care reform violates a number of conservative principles. But I cannot understand why so many good people would stick to conservative principles even when the demonstrable consequences are poverty and death for so many.
Is A Different GOP Possible?
In the wake of their biggest legislative defeat since the 1960s, it's time for principled conservatives to capture the Republican Party from the corporate class and the hateful class. I think it would be good for America. But it's going to take some political soul searching for them to get there.
Principled conservatives should ask themselves:
What positive agenda are we advocating?
Are there any compromises we are willing to make--any at all?
In what ways should modern conservatism differ from what we say "the Founding Fathers intended?"
Is it perhaps more than an embarrassing coincidence that we are so often on the same side of the issues as CEOs and the KKK?
It's my sincere hope that once the provisions of the health care bill come into effect, large numbers of principled conservatives will also ask themselves, "What the hell were we doing at those Tea Party protests?" But I'm not holding my breath. What's more likely is that the provisions will slowly and quietly become more and more popular, until one day even mainstream Republicans will defend them, like they're now doing with Medicare.