I'm less enthused than Jon Cohn by Carrie Budoff Brown's Politico story suggesting Republicans are in disarray on health reform. Brown's argument is that Republicans are in desperate need of a plan. I agree with that. But Budoff thinks they need a Republican plan. I think that's backwards. What they need is a Democratic plan. And soon enough, they'll get one. Jon, I think, indirectly makes the point, drawing the contrast to 1994:
Just days after Clinton formally delivered his plan to Congress, strategist Bill Kristol delivered his now-famous memo urging Republicans to oppose any universal coverage proposal rather than work on compromise. It quickly became the Republican leadership strategy, one they carried out in close coordination with an array of health industry groups.Meanwhile, Democrats squabbled among themselves and the big interest groups expected to support reform--labor and retirees--largely sat on the sidelines until it was too late. (Labor was still angry about Clinton's embrace of the North American Free Trade Agreement, which he'd just finished pushing over their objections; the AARP held off a big push because members had gotten spooked over prospective Medicare cuts.)In short, the right had more money, more unity, and more organization.
They also had the structural advantage of being in the opposition. Republicans didn't need a plan in 1994. Bob Dole, famously, voted against two separate proposals that he'd introduced. In general, the prospect of change is good for reformers and the specifics of change are good for obstructionists. Kristol's memo only made sense after Clinton's plan was introduced. Interest group squabbling only really commenced once there was something concrete to squabble over. Republican obstruction looked bad until they had specific provisions of a specific bill that could be used as justification. As Cohn says, reformers are much more united this time around. And they have, presumably, learned a lot since 1994. But so far we've seen the unions (and HCAN) arguing against anyone touching the employer tax exemption, we've seen Democratic congressmen erase the $300+ billion that would've been raised by changing the itemized tax deduction, we've seen the pharmaceutical and medical device industries lose their mind over comparative effectiveness. The only folks who have compromised on an actual policy issue so far are the insurers. I don't mean to be too much of a downer. The working relationship between Baucus and Kennedy is a big deal. So is the threat of reconciliation and Obama's poll numbers and the likely 59 senators on the Democratic side of the aisle and the existence of HCAN and much else. But it's worth remembering that the run-up to the bill is the part that makes the majority look good and the opposition look bad. One side wants good things, the other side opposes good things. Once you have a bill, it flips. Every large reform has unpopular provisions, and the parts can be used to doom the whole. The question is whether the reform coalition is strong enough to withstand the introduction of specifics.
