Monday, February 7, 2011

What Ryan Plan Financing Tells Us About Conservatives and Republicans

For those who are really interested in health care and the budget, especially those who buy the idea that ACA savings are probably overstated because they depend on budget discipline from future Congresses, I highly recommend Ezra Klein's post today skewering Paul Ryan's Medicare plan. The gist of it is that Ryan's plan is just as dependent on budget discipline in the future in the face of prospective real cuts as the ACA is.  So if you buy that criticism, Ryan's plan won't work either.

Of course, that's nothing compared to the GOP rhetorical strategy on ACA repeal, which is to specifically target the budget cuts included in reform as a front-tier talking point. And then there's the flat out myths (10/6, for example). And the whole doc fix thing -- hey, does Ryan's plan count the budget expense of doc fix?

All in all, it's just really hard to take budget concerns seriously as the root of GOP opposition to ACA.

Unfortunately, it's a bit hard to figure out exactly what the basis for opposition is. There's the tyranny and constitutional objections thing, but see Jonathan Cohn's point last week about social security privatization. Perhaps it's just based on myth and falsehood (that is, opponents really believe that ACA is all about the death panels), but that presumably shouldn't apply to elite opponents of the law. There's the idea that it's all about opposing whatever it is that Democrats want, which is true enough -- but doesn't really explain long-term opposition to health care reform, or why health care looms so much larger for conservatives than the other accomplishments of the 111th Congress.

My best guess is that it's bits and pieces of all of those, including at least some (mistaken but sincere, even if they're also willing to use arguments that cut the other way) concern about costs. The core of it, however, at least if I had to guess, is that ACA really is a "takeover" in the sense of really making affordable health care an absolute responsibility of the federal government. Such takeovers may or may not lead to expanding the size of government, or its direct reach into peoples' lives -- since the late 1970s, liberal Democrats have shifted to favoring market-based schemes for liberal ends. But even if it doesn't expand the size of government, it does expand the size of government obligation. And that's a pretty big deal, and one that conservatives are quite right, from their point of view, to oppose.

To speculate a bit more...

The problem for conservatives, however, is that they've lost the game long ago: it is clearly impossible for a viable national party to argue that the government should stand by and do nothing if costs are exploding, if insurance companies deny coverage to large groups, if insurance companies do all sorts of outrageous things to their customers. How do I know that? Because Republicans, despite pressure from Tea Partiers who say that they want a very small government and threaten primaries to those who disagree, feel obliged nevertheless to accept government responsibility for health care, at least rhetorically. That's why they claim to want to repeal and replace, not just repeal: they are rhetorically just as committed to a government solution as the Democrats, even as they are also committed to, well, not doing that. Next time you hear someone make a fuss about polling that shows conservative self-identification far higher than liberal self-identification, keep that in mind: whatever people mean when they say they're conservative, most of them surely don't think that the federal government should have little responsibility for health care. Or, for that matter, the economy.

All of which (along with some opportunism, something that all politicians and all parties are guilty of) makes for some remarkably incoherent policy pronouncements.

7 comments:

  1. Why does the GOP so oppose the ACA?

    Come on. This isn't brain surgery. The answer is really simple, and goes back to four simple words uttered by a well-known commentator in early 2009. Those words are:

    "I hope Obama fails."

    That's it. That's the entire, total, 100% reason they want to repeal ACA. They want Obama to fail. The ACA is Obama's single biggest legislative achievement in office so far. They expended enormous energy trying to stop it, because they knew that doing so would make it "Obama's Waterloo." After it passed, their goal became to repeal it before it becomes law. They know they are fighting a clock, and that after 2014 it will be basically impossible to repeal. But repealing will singlehandedly blow a hole in Obama's presidency through no fault of his own, instantly turning his signature achievement to mush. That would be a dream come true for them.

    This isn't complex. There is no psychoanalysis needed. The power base of the GOP cares about only one, two-level goal: seizing power, and paying off their rich buddies. That's it. They don't care about anything else, certainly not the welfare of the country, they don't care about anything at all except reaching this goal at all costs. And it's not enough that Democrats start helping the rich. After all, the individual mandate which they supposedly despise is going to help the insurance companies. That's why Republicans used to support it. That's why they called it "market-based" reform. "Market-based" is just one of the GOP's many, many euphemisms for doing anything to help big business.

    That's entirely what motivates them. It's what was really behind what Hillary called the "vast right-wing conspiracy." They didn't hate Clinton, and they don't hate Obama--they just hate being out of power, and if plotting to destroy the Democratic behemoths in power, using illogical arguments against things they once supported, is necessary to getting back where they want to be, they'll do it without breaking a sweat.

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  2. it's a bit hard to figure out exactly what the basis for opposition is.

    Really, it's not that hard. The American public has been told on numerous occasions by high-ranking GOP officials that the PPACA represents a "government takeover" of the entire health-care industry and will result in bureaucrats deciding whether or not to pull the plug on Grandma. You and I know that's not true. But the throngs of tea-partiers out there lap it up, and they do believe it's true.

    Now, you're right that this doesn't explain opposition from GOP "elites" who (presumably) should know better. But for them, the calculus is even simpler: the less popular PPACA is, the less popular Obama is, and the more likely it is that he will be defeated in 2012. In other words, "it's all about opposing whatever it is that Democrats want." So the "myths and falsehoods" keep on coming.

    (And there is no "long-term opposition to health care reform" that needs to be explained away - the GOP, as you note, does not oppose health care reform on principle, it just opposes whatever health care reform a Democratic president happens to be proposing.)

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  3. Off-topic but can one of you translate what Obama is saying in these two answers to Bill O'Reilly?

    At around the :50 second mark of the interview

    "Well, you know, he’s only he knows what he’s going to do but here’s what we know is that Egypt is not going to go back to what it was."

    At around the 5:11 mark of the interview.

    "That, that, the, uh, I mean if you are talking about the Wall Street Journal editorial page, you know, the uh, you know, that’s like quoting the New York Times editorial page."

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  4. I think another factor in the ACA-repeal hysteria is that political positions take on a logic and momentum of their own, which can detach them to some extent from any actual political goals. When ACA was pending but not yet passed, there was a good chance of stopping it, and the GOP turned shrillness up to 11 in hopes of doing this -- Hitler, socialism, death panels, etc. It almost worked, but not quite. However, once the thing has passed, you can't suddenly say, "Well, hey, we weren't serious about all that -- we know it's basically an incremental reform, which we still oppose but not all that hysterically." To some extent, at least rhetorically, you have to maintain the pretense that we're still facing the Death of Freedom.

    I can't think of examples, but I'm sure this is a dynamic we've seen before. It would be an interesting research project to go back and trace the route by which Republicans backed down from early claims about Medicare (socialism, Death of Freedom) and evolved into a party willing to claim to be its defenders. I suspect they'll be taking a similar route in this case.

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  5. I think Jeff is spot on about momentum.

    However, I think (as the result of totally ridiculous and snarky speculation) that health care has some key structural features which give it legs for crazy opposition: 1) It's a huge win (and goal) for the Dems. Huge. You punch healthcare and you punch hippies everywhere. 2) It touches everyone, so if you can get a seemingly winning strategy it can play *wide*. 3) It is a stunningly easy subject of incoherently demagoguery. This is great if you don't might or heartily enjoy incoherent demagoguery. (And it really is: Health and health care are subject to widespread anxiety and confusion. The solutions are hard and somewhat hard to explain well. The US is sucking out by key measures (cost/benefit, for example)---acknowledging that is unpatriotic. Huge fear of losing what you have (hence, keep the govt off my Medicare). It's not based on pure bigotry and yet there are plenty of bigotry opportunities. Etc. etc.)

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  6. Bijan's reasons also make a lot of sense -- the ease of demagoguery and the fact that it could play "wide" were obviously operating here. And beyond all this, we shouldn't overlook what Jonathan Cohn has been saying on his blog about this in recent days: that it's partly just a matter of "sheer pathology." Cohn quoting Greg Sargetn:

    "It's clear that for an untold number of base GOP voters, major questions about political and national identity are now bound up in repeal. An entire industry has been created around this new Holy Grail."

    Holy Grail quests, by definition, aren't rational -- they're based in myth and legend.

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  7. Bijan's reasons also make a lot of sense -- the ease of demagoguery and the fact that it could play "wide" were obviously operating here. And beyond all this, we shouldn't overlook what Jonathan Cohn has been saying on his blog about this in recent days: that it's partly just a matter of "sheer pathology." (http://www.tnr.com/blog/jonathan-chait/82875/the-pathology-repeal) Here's Cohn quoting Greg Sargent:

    "It's clear that for an untold number of base GOP voters, major questions about political and national identity are now bound up in repeal. An entire industry has been created around this new Holy Grail."

    Holy Grail quests, by definition, aren't rational -- they're based in myth and legend.

    (P.S. My comments appear but then immediately disappear if I try to code a URL as a hyperlink. This used to work but doesn't seem to anymore.)

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