No Country for Conservative Health Care Policy
~by Dan Miller
There’s something a bit frustrating about the health care debate that’s been going on here at the League. Health care has been THE liberal project for literally decades; entire careers (not to mention presidencies) have been built around it. There’s a vast policy apparatus on the progressive side of the aisle built around health care, with industrious wonks digging into every nook and cranny. Meanwhile, the right has…nothing. To the best of my knowledge, the right has never instituted any major policy shift in health care (with the exception of Medicare Part D, although even that came about substantially because of pressure from the left and with the help of liberal Senators). The right, speaking broadly, doesn’t see a problem with the current state of affairs in the health care system; it’s just not a subject that excites them. If there was a way they could continue the status quo while solving the problems of cost growth, I think most conservatives would gladly take it.
Into this gap steps E.D. Kain with a health care plan. And maybe it’s a workable one. I don’t actually know, I’m not a health care wonk; politics is my area of expertise. But E.D, and I mean no offense – I’ve got great respect for you – but you’re not even an A-list blogger. You have, as far as I know, no institutional backing; you certainly don’t have the ear of a Senator or 20. And yet you claim dissatisfaction because the plan that’s being debated in the House and Senate doesn’t match up to the lofty standards of the plan you offered in a blog post.
I’m a liberal. I’ve seen literally dozens of ideas on how to do health care and health insurance. It’s not like they’re a scarce commodity on this side of the aisle—every aspiring wonk has a few ideas. If having a plan was enough, this would have been done years ago. It’s not. You’ve got to put in the work—putting the ideological and institutional infrastructure in place, making clear that this is a priority, thrashing out the details of what you want. And all that work gets ruined and has to be redone the second you make contact with the political process. The current bill is not by any stretch a liberal dream bill. But it’s what we’ve determined is a) as best as possible, consistent with our priorities and b) politically feasible, after a 15-year-period where we planned this out.
Meanwhile, the right has basically abdicated its role in the conversation. It has not and as far as I can tell will not treat health care reform as any kind of priority—every major player on the right is sitting on the sidelines. If we’re lucky, we’ll get two GOP Senate votes. And this after not one but two elections in which the right was beaten by historic margins. So forgive me, E.D., but it’s hard to take your concerns with the weight they would deserve on another issue. On health care, you and yours simply haven’t put in the work.