David Frum contemplates conservative victory in the health care fight and doesn’t like what he sees:
The problem is that if we do that… we’ll still have the present healthcare system. Meaning that we’ll have (1) flat-lining wages, (2) exploding Medicaid and Medicare costs and thus immense pressure for future tax increases, (3) small businesses and self-employed individuals priced out of the insurance market, and (4) a lot of uninsured or underinsured people imposing costs on hospitals and local governments. [...]
Even worse will be the way this fight is won: basically by convincing older Americans already covered by a government health program, Medicare, that Obama’s reform plans will reduce their coverage. In other words, we’ll have sent a powerful message to the entire political system to avoid at all hazards any tinkering with Medicare except to make it more generous for the already covered.
If we win, we’ll trumpet the success as a great triumph for liberty and individualism. Really though it will be a triumph for inertia. To the extent that anybody in the conservative world still aspires to any kind of future reform and improvement of America’s ossified government, that should be a very ashy victory indeed.
These are good points. There’s a difference, of course, between a political win and a policy win. A policy win for conservatives would probably not be to block Obama’s proposals, but rather to modify them in exchange for the kind of “bipartisan” win that the White House and congressional leaders crave. Less generous minimum benefit packages, and therefore somewhat smaller subsidies. More financing through taxing health benefits and less financing through taxes on the rich and employer mandates. Encouragement of the administration’s efforts to cut waste out of Medicare rather than criticizing them.
That said, handing the White House a big bipartisan victory wouldn’t be helpful to Republican Party efforts to win elections in the future. Those crossed incentives interact with the anti-majoritarian elements of the congressional process in a way that makes certain kinds of compromises hard to pull off.