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December 21st, 2009 10:44 pm
How the GOP Lost Health Care … Years Ago
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Ross Douthat, who took over as the New York Times’ house conservative after Bill Kristol‘s brief stint during the 2008 election, has become increasingly insightful as he has settled into his new perch. In an entry on a NYT blog today, Douthat dissects the criticisms of the GOP approach to health care by The New Republic’s Jonathan Chait (a liberal) and former Bush speechwriter David Frum (a self-loathing Republican). Douthat doles out judicious criticism to each, but his own diagnosis is much more provocative:

In the end, when the history of the health care debate is written, I don’t think any of the choices that G.O.P. lawmakers made this year will loom particularly large. The choices that they made, or didn’t make, across the last fifteen years are what made all the difference. Between the defeat of Clintoncare and the election of Barack Obama, the Republicans had plenty of chances to take ownership of the health care issue and pass a significant reform along more free-market, cost-effective lines. They didn’t. The system deteriorated on their watch instead. And now they’re suffering the consequences.

Absolutely true. As good as many of the free-market healthcare reform ideas swimming around are, the reality is that, with the exception of marginal advances on Health Savings Accounts — a necessary, but not sufficient aspect of reform — the GOP has done nothing to advance an alternative vision for health care. And the party’s one major accomplishment was a massive and unfunded expansion of the welfare state in the form of the Medicare prescription drug benefit.

One other interesting note from Douthat:

As far as the Republicans’ rhetorical emphases go, meanwhile, I’d really prefer to live in a world where the G.O.P. hadn’t decided to remake itself as the party of Medicare now, Medicare forever. But judged purely as a short-term political strategy designed to derail the legislation, it’s hard to argue with the results. Public opinion has turned dramatically against the bill, and every swing-state Democrat who votes for it is courting political suicide.

Me: I’d gladly trade away potential GOP wins next year for defeating the health care bill now. After all, the point of  political victory is to influence policy outcomes.  And once the government embeds itself in the healthcare industry there will be no turning back — like our British counterparts, most of the domestic policy agenda will become focused on who can better manage a bloated welfare state.  The next few weeks may thus see the biggest epochal shift in American politics since the constituent parts of Reaganomics made their way through the Congress.

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