I like, but am a little confused by, Ezra Klein's post today about interest groups, Republicans, and the health care bill. His main point is a great one, and absolutely correct -- the big difference this time around compared to 1993-1994 is that this time, the interest groups are on board.
I've been using Clinton's health care reform defeat as an example while teaching the presidency for years, and what I've always told students was that one of the lessons was that in order to pass something Clinton needed to buy off at least two of the major interest groups involved, whether it was large employers, insurers, hospitals, doctors, or Pharma. Obama went one better than my suggestion; he got almost everyone on board, and made the bill tolerable for everyone else. So my first confusion is why Klein titled his post "Twilight of the interest groups." His point, and it's an important and I think correct one, is that Republicans didn't seem to care at all about the interest groups that one would expect to be important to their coalition. But the interest groups didn't suffer from that. Some won, some lost, as will all happen, but it's pretty clear that everyone, eventually even the pro-lifers, had a seat at the table. Of course, what threw everyone is that it was a purely Democratic table, and again Klein is correct that it didn't have to be. Still, the interest groups (collectively) did about as well as could be expected.
It seems to me that the real question here is whether the Republican Party will take a major hit. On the one hand, I don't think it's at all certain. Those who have said that if health care reform passes and is popular that the Democrats will benefit over the long term are, in my opinion, probably wrong. Medicare is wildly popular, and the truth is that the Civil Rights and Voting Rights bills from 1964 and 1965 are wildly popular today. Yet the Democrats didn't benefit from these things electorally, not just because of race in the South, and not just because of Vietnam, but because they rapidly became just part of the normal things that government does. What passing health care reform will do, if the plan works, is to reduce the importance of an issue that's worked well for Democrats for decades.
However, on the interest group side, I think the risks for the Republicans are pretty large. There are a lot of interest groups that have always been part of the GOP coalition that may just walk after this. I don't think it will happen overnight -- among other things, groups might hesitate to leave a party that might take over the House in November -- but if the Democrats keep the House, and start looking like a party that might hold majorities for an extended period, they're going to be in a pretty good position to attract some groups that have always fallen on the other side of the aisle.
To put it another way: Republicans may be forced to choose between being the party of the tea parties, Rush, and Beck, or a party that can compete on even terms with the Democrats. The danger here is that they could easily choose the former. It seems like a pretty viable business plan -- take extreme positions, inflame your audience, and use the anger to squeeze every possible cent out of them. But I don't see why groups like Pharma or the doctors (or other groups that will matter on climate/energy and other issues) would bother to stick around for that.
Hey, I'm not predicting anything. But I do think that Republicans may have to make some choices. The need to do that will be reduced if they take control of the House this November (which might happen, regardless of health care or any of this stuff, if the economy is lousy enough), but especially if that doesn't happen, 2011 is going to be a very interesting year for the Republican Party.