Because I’m tired of explaining a conservative health care law to conservatives

December 6, 2013 at 11:30 am

If you haven’t noticed yet, the conservative wedge issue for 2014 is going to be health care.

Democratic Senators like Mary Landrieu have noticed.


They simply don’t appear to have much of a strategy to date: 1) apologize for the horrible website, 2) focus on the economy, and 3) keep explaining to conservatives why a conservative solution is not such a bad thing.

If we can’t do better, well before November, expect to lose the Senate.

One and two are decent steps but they are not going to take health care off the table as an issue.

And the problem with explaining a conservative solution to conservatives is twofold:

  1. Every liberal I know recognizes that the ACA is a conservative solution. We think it’s a step but we really believe there are better solutions.
  2. We’re beating our heads against a wall trying to convince conservatives that a solution originally proposed by conservatives is right for the country despite conservative media telling them otherwise.

There is one time and one time only when conservative leadership has supported any kind of health care reform.

Conservative think tank strategy makes heavy use of a concept called the Overton window. You can also think of this as shifting the center.

The Overton window is the range of actual, reasonable possibilities as perceived by the general public. Anything outside of this is radical or unthinkable. (Hat tip to dKos writerthereisnospoon for first bringing this to light).

If you look at healthcare options on the spectrum from universal single payer health care to completely unregulated market solutions, it might look something like this:

–    No government involvement in health care insurance
–    Health care industry loosely regulated by government / no mandate
–    Individual mandate / health care insurance exchanges (ACA)

–    Business mandate / health care insurance exchanges
–    Managed competition – The Clinton plan
–    Public option
–    Medicare for all
–    Single payer/universal healthcare

Now I could probably do a better job at this list but bear with me for a second. This is solely meant to illustrate the concept.

The options in bold represent the current Overton window. Notice the more government-centric plans are considered radical or, in Republican terms, socialist these days.

Anything not in bold is considered not politically possible and/or radical by today’s Washington establishment.

The problem is that the only time conservatives have ever supported anything other than a completely unregulated market has been when government-based solutions were on the table.

A Brief History

The 1970s. From the Washington Spectator:

When Ted Kennedy chaired the Health subcommittee in the early 1970s, Nixon introduced an early version of the ACA called the Comprehensive Health Insurance Plan (CHIP) that included an employer mandate and subsidies for low-income families.

1989. Stuart Butler at the Heritage Foundation introduces the individual mandate, the basis for Romneycare and Obamacare.

Here, in Butler’s own words, is why:

Increasingly, pressure is building for some kind of national health insurance system in America. I believe that eventually the U.S. will have a “national health system,” in the sense of a system that assures each citizen of access to affordable health care. At issue is the kind of national system we should have.

1992 and 1993. Butler’s ideas were used by Republicans in Congress as they sought an alternative to Bill Clinton’s health care reform. The Health Equity and Access Reform Today Act (or HEART) was introduced by Lincoln Chafee and co-sponsored by 19 Senate Republicans including Bob Dole, Chuck Grassley, Orrin Hatch, and Alan Simpson.

Are you sensing a pattern?

Republicans only support any kind of health care reform when better, government programs are possible and gaining momentum (within the Overton window).

What would this look like as a strategy?

A better strategy than sitting back on our heels, pinned in by the ridiculous limitations of conventional Washington “wisdom,” would be to keep fighting for something we actually believe in.

In other words, shift the Overton window instead of accept it.

The beautiful thing is, Republicans are generating the outrage. Why not take advantage of it?

Every time they come out with their latest salvo against the ACA, we should push for a better program. Every time they yell “Repeal and Replace” we should shout: “We’re with you! Let’s expand Medicare for everyone!”

Why aren’t we attacking instead of forcing liberals to defend a program we never wanted to begin with?

Imagine Democratic members of Congress actually having a response to Republican attacks on the ACA instead of limply trying to justify the solution:

There’ve been some early issues with the Affordable Care Act. We’re committed to making it better, but if it doesn’t work, we have proven alternatives. One is Medicare. I’m introducing a bill in the Senate this week to expand Medicare to everyone.

Then when Republicans vote for the 48th time to repeal the ACA (and yes, they’ve already voted 47 times to repeal), hold a vote in the Senate to expand Medicare. Make Republicans explain why they’re not in favor of a better alternative.

It’s a no lose scenario. Best case, we turn Republican outrage into a better program. While I don’t think this is likely, wouldn’t it be ironic if Republican-generated outrage led to single payer?

My guess is that if we take up their battle cry, the conservative outrage machine dials back the anger. At the very least, we show that Republicans aren’t really interested in better solutions.

ACTION: If you think this makes sense and have a Congress person willing to listen, call them or write them and suggest a better strategy. And sign the petition to Pass Medicare for All. Because when has looking weak ever paid off politically.

Original article available at: The Washington Spectator.

Cross posted at: DailyKos.