*snip*
Yet even as Republican politicians seem ready to go on the offensive, theres a palpable sense of anxiety, even despair, among conservative pundits and analysts. Better-informed people on the right seem, finally, to be facing up to a horrible truth: Health care reform, President Obamas signature policy achievement, is probably going to work.
And the good news about Obamacare is, Id argue, whats driving the Republican Partys intensified extremism. Successful health reform wouldnt just be a victory for a president conservatives loathe, it would be an object demonstration of the falseness of right-wing ideology. So Republicans are being driven into a last, desperate effort to head this thing off at the pass.
Some background: Although youd never know it from all the fulminations, with prominent Republicans routinely comparing Obamacare to slavery, the Affordable Care Act is based on three simple ideas. First, all Americans should have access to affordable insurance, even if they have pre-existing medical problems. Second, people should be induced or required to buy insurance even if theyre currently healthy, so that the risk pool remains reasonably favorable. Third, to prevent the insurance mandate from being too onerous, there should be subsidies to hold premiums down as a share of income.
Is such a system workable? For a while, Republicans convinced themselves that it was doomed to failure, and that they could profit politically from the inevitable train wreck. But a system along exactly these lines has been operating in Massachusetts since 2006, where it was introduced by a Republican governor. What was his name? Mitt Somethingorother? And no trains have been wrecked so far.
This is why I've never been interesting in the arguments for or against the policy based on whether it would 'work' (such an approach also begs the question of what one means by 'work', as everyone seems to have a different end game in mind with health care reform). The pragmatic argument leads us into ends-justifies-the-means thinking, and with government the means is crucially important. Any number of unjust, freedom-killing initiatives could 'work' when it comes to solving social problems. Slavery 'worked' for hundreds of years.