Conservatives went into the healthcare fight with many tactical advantages.
1) We were the party of the status quo … always the strongest position in America’s interest-bound politics.
2) We were the party in opposition – and people of widely different points of view will find it easier to unite around what they oppose than what they support.
3) We could raise questions that forced proponents into the impossible position of having to prove negatives. Could they PROVE the plan did NOT create death penalties? Could they PROVE the plan would NOT promote abortion?
4) The healthcare consumers who will lose under the plan – enrollees in Medicare Advantage – are the country’s best informed and most active citizens. The winners – recent immigrants, the very sick – are people who do not normally involve themselves in politics much.
Those tactical advantages were offset by a strategic dilemma, and it’s that dilemma that may have proved fatal.
Republicans and conservatives want two things in the healthcare debate:
1) They want to hold the line on costs, because those costs fall heavily on core Republican constituencies: small business, the elderly.
2) They want to preserve the freedom of healthcare providers to do business in their own way, free of government interference.
But of course you can’t have both!
In past debates, the GOP tilted more in favor of principle 1. But this year it was principle 2 that usually received precedence. (Perhaps because so much of the money and energy behind the tea party movement was quietly provided by people with a strong financial stake in principle 2.)
Complying with principle 2, we argued that any reduction of health spending in any way or form amounted to state-sponsored mass murder; any impinging on the freedom of doctors and insurers to carry on their business as they pleased amounted to fascist tyranny.
But the more we urged principle 2, the more we cut ourselves off from the institutional supporters of the Republican party, the taxpayers, small business owners and corporate leaders most concerned with principle 1.
Not that the Democrats did so much better with the groups that cared about principle 1. They threw away that opportunity by their own misplaying. But they didn’t need those groups as intensely as the Republicans did.
Without them, it proved impossible to constrain the votes of moderate senators. In the end, even Joe Lieberman – sensitive as he was to industry concerns – knuckled under to the Democratic party whip.
It would be premature to say conservatives have lost this fight. There’s still hope. But it grows faint … and our own miscalculations explain much of why.