As isolated as Republicans appear to be in Washington, they often find allies in the struggle to keep the federal government from becoming the command-and-control center of American life. The U.S. Chamber of Commerce and other business groups have stymied organized labor's drive for legislation ("card check") to unionize workers without a secret ballot election. Moderate Democrats in Congress have joined the opposition to the perilous plan ("cap and trade") to limit carbon emissions at the expense of a growing economy.
But there's one issue on which Republicans are alone and President Obama and Democrats have the upper hand: health care. Indeed, the prospects have never been better for expanding Washington's role in even the smallest decisions made by doctors and patients. Thwarting this won't make Republicans more popular. Their efforts might be in vain. But at least they'll be heroes in the cause of defending private health care and preserving individual freedom. They'll vindicate their existence as Republicans.
Obama's liberal reforms would probably be irreversible. Most ominous is creation of a government health insurance program open to everyone. The respected Lewin Group estimates such a program would soon cover 130 million Americans, most of them refugees from private insurance. It would only be a short step to a Canadian-style, single payer system run by bureaucrats in Washington.
It's worth noting how Canadian health care failed to save the life of actress Natasha Richardson after a recent ski accident. The nearby hospital had no scanning equipment or neurosurgeon, and there was no helicopter to fly her to a trauma center. By the time she arrived at one, she was brain dead. Why wasn't proper treatment and equipment at hand? Government had decided not to pay for them.
In taking up health care legislation, this isn't 1994. Back then, Republicans, conservatives, and queasy Democrats worked with doctors, pharmaceutical companies, hospitals, HMOs, and insurers to defeat the scheme cooked up by Hillary Clinton. It failed without being reported out by any committee in a Democratic Senate or House.
Times have changed. Fifteen years of one-sided discussion of soaring costs, the plight of the uninsured, and the heartlessness of insurance companies have increased demand for more and cheaper health care. And Obama has learned from the Clintons' mistakes.
The Clinton proposal was developed at the White House with little contribution from congressional Democrats, the folks who would have to approve it. In addition, the Clinton team was unwilling to accommodate either allies or critics who wanted to reach a compromise on health care. Hillary Clinton stood her ground, until it crumbled beneath her.
Obama, in contrast, has assigned Democrats in Congress the task of drafting the health care bill. This is both smart and politically safe. They're in sync with Obama on a mandate that every American have health insurance with generous minimum benefits, that businesses offer it to employees or pay a stiff fine, and that people have the option of switching to government health insurance.
That's not all. Obama and other Democrats now talk about health care in a more appealing fashion. "They've co-opted Republican rhetoric on health care," a leading Washington lobbyist says. They've learned this from extensive polling. Would voters like the option of choosing between employer-based health insurance and a government insurance program? Of course they would, particularly when the word "public" is substituted for "government."
And rather than replace employer-purchased insurance, the "public" plan would merely "compete" with it. The competition might not last long, as we discovered in 1965 when Medicare drove private insurers out of business and quickly became the only plan for seniors. That's exactly the effect a government health insurance option would have now. By offering cut-rate fees and drug prices--it wouldn't need to make a profit--it would soon clear the field of competitors.
Obama and company have one more big advantage. For the first time since the 1960s, liberal Democrats control Washington. Their freedom to do what they please has been enhanced by the economic downturn. On top of that, Obama argues that health care reform is a precondition for economic recovery, though he must know it really isn't.
For now, the natural opponents of Obamacare are divided and fearful. Doctors are not engaged. Hospitals are concerned with the narrow issue of fees paid by the government. Insurance companies and the pharmaceutical industry are terrified of crossing Obama. The conservative movement hasn't set its sights on stopping the president on health care.
Tea parties won't suffice. It's up to Republicans to rally a well-financed army of relentless opposition--not for the good of the party, but for the good of the country. And who knows? Obamacare might suffer the fate of HillaryCare. Stranger things have happened in Washington.