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The Republican Health Care Blunder

The United States is on the doorstep of comprehensive health care reform. It's a staggering achievement, about which I'll have more to say later. but the under-appreciated thing that strikes me at the moment is that it never would have happened if the Republican Party had played its cards right.

At the outset of this debate, moderate Democrats were desperate for a bipartisan bill. They were willing to do almost anything to get it, including negotiate fruitlessly for months on end. We can't know for sure, but Democrats appeared willing to make enormous substantive concessions to win the assent of even a few Republicans. A few GOP defectors could have lured a chunk of Democrats to sign something far more limited than what President Obama is going to sign. And remember, it would have taken only one Democrat to agree to partial reform in order to kill comprehensive reform. I can easily imagine a scenario where Ben Nelson refused to vote for anything larger than, say, a $400 billion bill that Chuck Grassley and a couple other Republicans were offering.

But Republicans wouldn't make that deal. The GOP leadership put immense pressure on all its members to withhold consent from any health care bill. The strategy had some logic to it: If all 40 Republicans voted no, then Democrats would need 60 votes to succeed, a monumentally difficult task. And if they did succeed, the bill would be seen as partisan and therefore too liberal, too big government. The spasm of anti-government activism over the summer helped lock the GOP into this strategy -- no Republican could afford to risk the wrath of Tea Partiers convinced that any reform signed by Obama equaled socialism and death panels.

The role of Olympia Snowe is interesting here. Snowe negotiated seriously for months, and Democrats met what seemed to be her substantive concerns, but, like the Russian army retreating before Napoleon, she insisted that the bill be drawn out indefinitely. Snowe demanded that the process not be rushed, but she never defined what a reasonable time frame would be. In the summer, "taking your time" and "doing it right"meant waiting until after the August recess. In the fall, it meant until after Thanksgiving. Now it means until after Christmas. If it lasted until next year, eventually Republicans would demand that the process not be rushed before the midterm elections, and that the fair thing would be to let the people decide in the 2010 elections.

The GOP leadership has every incentive to stretch the process out as long as possible. It runs out the clock on the first two years of the Obama presidency, after which high unemployment and the natural effects of an off-year election would produce a Congress far less likely -- perhaps totally unwilling -- to cooperate with Obama. Snowe might have diverged from the party line on substance, but she seems to have agreed to hold the line on process. At some point, process becomes substance. Thus Snowe effectively removed herself from the negotiations.

And so Democrats found themselves all alone. It seems to be around August when the party realized that bipartisan dealmaking was not at hand, and it had to pass a bill or face the same calamity as it did in 1994. Politically speaking, there were no good options left, but passing a bill offered the least bad option. The unified partisan front of the Republican Party forced the Democrats to adopt their own unified partisan front, something that appeared impossible as recently as this last summer. This passage from the New York Times is telling:

Faced with Republican opposition that many Democrats saw as driven more by politics than policy disagreements, Senate Democrats in recent days gained new determination to bridge differences among themselves and prevail over the opposition.

Lawmakers who attended a private meeting between Mr. Obama and Senate Democrats at the White House on Tuesday pointed to remarks there by Senator Evan Bayh, Democrat of Indiana, as providing some new inspiration.

Mr. Bayh said that the health care measure was the kind of public policy he had come to Washington to work on, according to officials who attended the session, and that he did not want to see the satisfied looks on the faces of Republican leaders if they succeeded in blocking the measure.

Evan Bayh! When you've turned the somnolent, relentlessly centrist Indiana Senator into a raging partisan, you've really done something. The Republicans eschewed a halfway compromise and put all their chips on an all or nothing campaign to defeat health care and Obama's presidency. It was an audacious gamble. They lost. In the end, they'll walk away with nothing. The Republicans may gain some more seats in 2010 by their total obstruction, but the substantive policy defeat they've been dealt will last for decades.

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