Thursday, October 3, 2013

Obamacare: The Sum of All Republican Fears

Obamacare is up and running—or at least crawling, and the Republicans are madder than hell and swear they will take down this evil scheme to provide healthcare for all. Even for those who believe that intelligence and learning are hindrances for Republican legislators, the current stance of the party is exceptional. Why are they acting as if Armageddon is upon us and the nation might have to be destroyed in order to save it? What exactly is so frightening to them about Obamacare?

Ross Douthat tries to provide an intellectual underpinning for this fight to the death in a note in the New York Times titled Why the Right Fights. He claims that neither the left nor the right appreciates the long-term historical viewpoints of the other. The left views social programs such as Social Security, Medicare and Medicaid as fundamentals of national life, not as progressive victories. Any attack on them is on a par with restricting access to food and water. The left views the Reagan/Bush years as a period when conservatism had its way and caused untold harm to society.

On the other hand, the small government forces view the Reagan/Bush years as a failed opportunity. Government growth was not turned around—it was barely slowed down. The current wave of Tea Party enthusiasm has also turned out to be unsuccessful—thus far—in reigning in big government.

"But to many conservatives, the right has never come remotely close to getting what it actually wants, whether in the Reagan era or the Gingrich years or now the age of the Tea Party — because what it wants is an actually smaller government, as opposed to one that just grows somewhat more slowly than liberals and the left would like. And this goal only ends up getting labeled as "extreme" in our debates, conservatives lament, because the right has never succeeded in dislodging certain basic assumptions about government established by F.D.R. and L.B.J. — under which a slower rate of spending growth is a "draconian cut," an era of "small government" is one which in which the state grows immensely in absolute terms but holds steady as a share of G.D.P., and a rich society can never get rich enough to need less welfare spending per capita than it did when it was considerably poorer."

Douthat suggests that it is generations of frustrations accumulating and bringing the Republicans to a breaking point rather than anger at Obamacare as a specific program that has led to the current standoff.

"So what you’re seeing motivating the House Intransigents today, what’s driving their willingness to engage in probably-pointless brinksmanship, is not just anger at a specific Democratic administration, or opposition to a specific program, or disappointment over a single electoral defeat. Rather, it’s a revolt against the long term pattern I’ve just described: Against what these conservatives, and many on the right, see as forty years of failure, in which first Reagan and then Gingrich and now the Tea Party wave have all failed to deliver on the promise of an actual right-wing answer to the big left-wing victories of the 1930s and 1960s — and now, with Obamacare, of Obama’s first two years as well."

Douthat points out the reason why previous Republican generations have failed is because what they wanted to do was unpopular and they didn’t dare try to implement the changes they wished.

"....when it comes to the question of whether the state should meaningfully shrink its footprint in our society, American political reality really does seem to have a liberal bias. And so the process....has played out repeatedly in our politics: Conservative politicians take power imagining that this time, this time, they will finally tame the New Deal-Great Society Leviathan … and then they make proposals and advance ideas for doing so, the weight of public opinion tilts against them, and they end up either backpedalling, getting defeated at the polls, or both."

The Republican right—millennial version—comes across in Douthat’s description as a band of eccentric—perhaps even romantic—idealists determined to joust with one more windmill.

Douthat is perhaps too kind to this merry band of men. There are other interpretations of their actions and motives.

Eduardo Porter provides another perspective in a New York Times article: Why the Health Care Law Scares the G.O.P. In his view, the Republican Party’s attempt to deny healthcare coverage to tens of millions is based on the most craven of political calculations.

Porter uses the politics of the state of Missouri to illustrate what only appears to be irrational behavior. There was considerable support for state expansion of Medicaid for the poor and disabled under Obamacare. The Chamber of Commerce was in favor of expansion as it pointed out that Missouri hospitals would lose up to $4.2 billion in federal support over the next six years. Roughly half of the 800,000 uninsured in Missouri would have become eligible for Medicare.

"Pragmatism suggested accepting the expansion. Washington would pay the extra cost entirely for three years and pick up 90 percent of the bill thereafter."

"And it would expand health coverage in the state’s poor, predominantly white rural counties, which voted consistently to put Republican lawmakers into office."

"Missouri’s Republican-controlled Legislature — heavy with Tea Party stalwarts — rejected Medicaid’s expansion in the state anyway."

Are these Tea Party types a band of idealists standing up for a principle they hold dear? Porter thinks not. In his view, Obamacare could be successful enough to join Social Security, Medicare, and Medicaid as a popular program that became untouchable.

"....the argument that half the Republican Party has simply lost its mind has to be an unsatisfactory answer, especially considering the sophistication of some of the deep-pocketed backers of the Tea Party insurgency."

"There is a plausible alternative to irrationality. Flawed though it may turn out to be, Obamacare, as the Affordable Care Act is popularly known, could fundamentally change the relationship between working Americans and their government. This could pose an existential threat to the small-government credo that has defined the G.O.P. for four decades."

The greatest benefit from Obamacare will be felt by those who have had too high an income to be eligible for Medicaid, and too low an income to be able to afford health plan premiums. These are exactly the people (white) that the Republicans depend on to vote them back into office.

"As it turns out, the core Tea Party demographic — working white men between the ages of 45 and 64 — would do fairly well under the law."

"Take Missouri. It has about 800,000 uninsured. Almost half of them would have been eligible for expanded Medicaid benefits, had the Legislature not rejected them. Many of the rest — including families of four making up to $94,000 — will be eligible to get subsidized health insurance."

"In St. Louis, for instance, a family of four making $50,000 a year will be able to buy a middle-of-the-road "silver" health plan for $282 a month and a bottom-end "bronze" plan for $32. Even Medicare recipients will get a benefit worth a few hundred dollars a year."

"This could justify conservative Republicans’ greatest fears."

The Missouri Republicans chose to withhold needed medical care from its own most faithful partisans in order to make sure that they did not receive a benefit for which they might be appreciative. They might even think kindly of Democrats for saving a life or two here and there. That can never be allowed to happen.

Douthat seems to view the current Republican Party as an evolution of traditional conservatism, but these people are not related to his New England examples of years past. These aren’t small-government enthusiasts; they are no-government enthusiasts. They do not want to take the country back to the glory days of unfettered capitalism; these people have a more Southern heritage and would rather reinstate the eighteenth century.

They seem to yearn to return to a day when wealth could be accumulated with no restrictions on methods used. If slavery was no longer practical, then low-wage serfdom was just fine. Pensions and healthcare? Who needs them? In the good old days people worked until they died, and the minimum wage was what God intended: the wage below which a person was too weak to show up for work.

Let these people have their last stand. When they fail, one hopes they have the decency to fall on their swords and disappear forever.

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