Friday, March 26, 2010

It's a done deal

Barack Obama scored a big victory, both in terms of policy and politics. Wanting to get some Republicans on board, Democrats spent the last year crafting a bill that Republicans – or at least large numbers of them – should love. It is built on a series of principles that Republicans espoused for years. Republicans have said that they do not want to destroy the private insurance market. The new healthcare reform law not only preserves that market but strengthens it by bringing in millions of new customers.

Regardless of what they say on the talk shows, Republicans know that the plan does not call for a government "takeover" of health care. It provides subsidies so more people can buy private insurance. Republicans always say they are against "socialized medicine". Well, this bill is far from socialized medicine. It is nothing like a "single-payer" health system along Canadian or British lines. It does not even include the "public option" that would have allowed people voluntarily to buy their insurance from the government which, in turn, would have given insurance companies competition and force them to keep their costs down. (I predict that Congress will have to revisit the issue relatively soon to address the rising increase of health insurance premiums.)

Republican leaders, who have only thought of getting back power ever since the Democrats won their majority, think that they have just been handed a heavy political poll-studded cudgel with which to hammer Democrats in the fall, but they better think again. Moderate Republican David Frum's “GOP Waterloo” theory is getting a lot of buzz. He says that the healthcare bill is Republicans’ and conservative Democrats’ most crushing legislative defeat since the 1960s – not only for reasons of politics, but because healthcare reform will be an enduring policy. The bill will not get repealed, but when Republicans take power again, they will likely tweak it – tinker around the corners of it. Maybe they will add tort reform, or purchasing across state lines, or change how it's funded. But now that healthcare reform has been signed, the future holds healthcare reform, not repeal.

Frum wrote:

“At the beginning of this process we [Republicans] made a strategic decision: unlike, say, Democrats in 2001 when President Bush proposed his first tax cut, we would make no deal with the administration. No negotiations, no compromise, nothing. We were going for all the marbles. [Republicans believed] this would be Obama’s Waterloo – just as healthcare was Clinton’s Waterloo in 1994. Only, the hardliners overlooked a few key facts: Obama was elected with 53% of the vote, not Clinton’s 42%. The liberal block within the Democratic congressional caucus is bigger and stronger than it was in 1993-94. And of course the Democrats also remember their history, and also remember the consequences of their 1994 failure. This time, when we [Republicans] went for all the marbles, we ended with none.”

There is little question that the new Affordable Care Act, the lawsuits against it (both credible and talking points-based), and the Republican "repeal" movement will keep the Tea Party activists energized and engaged. Off-year elections are about mobilizing the party base. Independents remain the key voting group in politics.

Frum also wrote:

“When Rush Limbaugh said that he wanted President Obama to fail, he was intelligently explaining his own interests. What he omitted to say – but what is equally true – is that he also wants Republicans to fail. If Republicans succeed – if they govern successfully in office and negotiate attractive compromises out of office – Rush’s listeners get less angry. And if they are less angry, they listen to Limbaugh’s show much less – then he gets less money.

“So today’s defeat for free-market economics and Republican values is a huge win for the conservative entertainment industry. Their listeners and viewers will now be even more enraged, even more frustrated, even more disappointed in everybody except the responsibility-free talkers on television and radio. For them ‘It’s mission accomplished’. For the cause they purport to represent: ‘It’s Waterloo all right: ours [meaning Republicans].’ ”

It didn't take long – and the GOP knew it, which is why they fought so hard against HCR passing – new poll numbers show a positive shift in opinions toward the Democrats. These numbers suggest that running on a promise to repeal the Affordable Care Act or shift healthcare policy to the right is not much of a winning strategy. Americans by 9 percentage points have a favorable view of the health care overhaul that President Obama signed into law Tuesday. A poll by USA Today/Gallup finds a notable turnaround from surveys before the vote that showed a plurality against it. By 49%-40% those surveyed say it was "a good thing" rather than a bad one that Congress passed the bill. Half describe their reaction in positive terms, as "enthusiastic" or "pleased," while about four in 10 describe it in negative ways, as "disappointed" or "angry." The largest single group, 48%, calls the bill "a good first step" that should be followed by more action on health care. An additional 4% also have a favorable view, saying the bill makes the most important changes needed in the nation's health care system. Bonus stat: President's approval rating on health care 46%; GOP approval rating on health care 26%.

In a CNN poll, a question shows that 51 percent of the public trust Obama versus 39 percent who trust Congressional Republicans. Similarly, another question shows that 45 percent trust the Democrats versus only 39 percent who trust the Republicans.

All these numbers suggests that running on a promise to repeal the Healthcare Act will not work in favor of the Republicans. (I hope they do not realize this until it is too late.) The Party of No is losing. As it is, however, the lock-step march of the Republicans in radical resistance to even the most modest proposals to heal a deeply ailing nation leaves the Democrats as the only party that matters. The Republicans are a party of incoherent rage, and while they might temporarily succeed as demagogues, they are now acknowledged strangers to fact and logic – not to mention compassion.

Now that the bill has actually passed, independents will begin to forget the ugly process and start focusing more on the substance – the goodies they get from the bill. Talk of death panels, deem and pass, and reconciliation will fade away. Every news outlet in the country already has stories and charts showing people what they get under the new law. Once the public realizes the goodies they get, Republican candidates – and conservative Democrats – will not want to insist on repealing the bill – which would be the same thing as insisting that children be kept off of health insurance once again because they have a pre-existing condition, or that a sick person can be kicked out of their insurance plan, or that small businesses should not get the 35% tax credits to help pay for their employees' health insurance. Even if Republicans scored a 1994-style landslide in November, how many votes could they muster to re-open the 'doughnut hole' and charge seniors more for prescription drugs? How many votes would it take to re-allow insurers to rescind policies when they discover a pre-existing condition? How many votes could they get to banish 25-year-olds from their parents' insurance coverage? Who really wants to repeal the ban on annual and lifetime insurance payment limits?

The seniors will be really happy that the donut hole for their drug coverage is closing, although they do lose the overpriced upper-end Advantage C Medicare plans for which Medicare, through taxpayers, pay private insurance companies more than if the seniors stayed with regular Medicare. This will extend Medicare's solvency for 10 more years beyond the previously predicted date.

By November, David Frum argues, "the immediate goodies in the healthcare bill will be reaching key voting blocs" – and they are going to love what they have. Even if the Affordable Care Act moves from unpopular to merely neutral, Tea Party-driven mania for repeal will be out of sync with the majority of the public, especially if Democrats are focusing their public conversation on jobs.

Word is already getting out about how the deficit will be REDUCED by 1.3 trillion dollars during the first 20 years the reform plan is in effect. Can you guess what happens to the GOP when the public begins to understand and enjoy the goodies in the bill? Soon the public will be shouting: “Keep your hands off my Obamacare!” This could actually turn into a Republican Waterloo, especially if the economy begins to turn around for Main Street.

Healthcare reform is a done deal.