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Card 'Em

How to nudge Americans skeptical of health reform.

When Barack Obama signed the Patient Protection and Affordable Care Act into law yesterday, it became official: health care was not to be, as certain Republicans promised, the president’s Waterloo. Republicans quickly swung to predicting that health care would instead be a deceptively successful but actually disastrous victory—more like Napoleon’s conquest of Moscow, say, which launched his bloody winter march from power. Obama and the Democrats will realize the folly of their health care triumphalism, Republicans say, when the midterm elections roll around.

Should Democrats buy into this narrative? No, and here’s why: The solution lies right in my wallet.

And the wallets of the millions of other Americans who have crossed the 65 year mark since 1965: a little red, white, and blue Medicare card. The day President Obama signed the HCR bill into law every American became eligible for a little card of her own. I haven’t seen the Obama message gurus produce one, so I did it for them.

When Lyndon Johnson signed the law that created Medicare, he had two Medicare cards ready: one for Harry Truman and one for his wife, Bess Truman. Nice gesture. But the Trumans were already going to vote Democratic. What a waste.

George W. Bush, whose record on reelection is substantially superior to that of Lyndon Johnson, knew better. When he achieved the record-setting tax cuts in 2001, taxpayers received not one, but two missives from the Republican controlled federal government. First they got a letter, telling them they were going to get a tax rebate. And then they got a rebate check (postmark: Austin, Texas, the president’s campaign headquarter city), printed with the slogan “tax relief for America’s workers,” which had been a hallmark of the Republican campaign.

Long ago, people who study political behavior noticed something weird. When people don’t have something, they are pretty rational about what they’d be willing to pay to get it. But when they already have something, they pay wildly more not to lose it, even if it’s the same thing. The Obama folks should not need me to tell them this; I learned it from one of the president’s advisors, the behavioral economics guru Cass Sunstein. He wrote about it in his book, Nudge. Put an Americare Card in the hands of every adult and parent in America and then let the Republicans come for it. I’m guessing, in the words of a great Republican, Charlton Heston, they’d have to pry it out of our cold dead hands.

Linda Hirshman is a retired professor of philosophy. She is at work on a book about the gay social movement.