Medicare built on Franklin D. Roosevelt's New Deal notion of government as insurer, with citizens making payments to government, and government paying out benefits. That was the central idea of Social Security, and Medicare piggybacked on Social Security.
Obama's legislation comes from an alternative idea, begun under the Eisenhower administration and developed under Nixon, of a market for health care based on private insurers and employers. Eisenhower locked in the tax break for employee health benefits; Nixon pushed prepaid, competing health plans, and urged a requirement that employers cover their employees. Obama applies Nixon's idea and takes it a step further by requiring all Americans to carry health insurance, and giving subsidies to those who need it.
So don't believe anyone who says Obama's health care legislation marks a swing of the pendulum back toward the Great Society and the New Deal. Obama's health bill is a very conservative piece of legislation, building on a Republican rather than a New Deal foundation. The New Deal foundation would have offered Medicare to all Americans or, at the very least, featured a public insurance option.
For a right-wing take on it that's remarkably similar, here's conservative commenter, and former Bush speechwriter, David Frum:
But we do know that the gap between this plan and traditional Republican ideas is not very big. The Obama plan has a broad family resemblance to Mitt Romney’s Massachusetts plan. It builds on ideas developed at the Heritage Foundation in the early 1990s that formed the basis for Republican counter-proposals to Clintoncare in 1993-1994.
Hilariously, Mitt Romney is busy running away from his own record in Massachusetts. Well, everyone in the GOP is running to the far right just as fast as they can, terrified of being labeled a "moderate." It's the French Revolution all over again, but in a rightward direction. When extremists are in control, no one is ever extreme enough. These days, all Republican politicians are desperate to show no taint of moderation or compromise.
But Romney, of course, has a lot farther to run than most. Luckily, he has no principles at all. Here's his comment on the health care reform bill that's actually similar to what Romney himself passed in Massachusetts:
His health-care bill is unhealthy for America. It raises taxes, slashes the more private side of Medicare, installs price controls, and puts a new federal bureaucracy in charge of health care. It will create a new entitlement even as the ones we already have are bankrupt. For these reasons and more, the act should be repealed. That campaign begins today.
Funny, isn't it? Are even Republicans so dumb that they can't see through Mitt Romney? More importantly, are the rest of us actually dumb enough to believe the right-wing slanders about health care reform? Certainly, the local media here in Nebraska seem to think so. They're busy following the lead of Fox News. It's really embarrassing.
But Frum, at least, seems to be worried that his team has shot itself in the foot:
No illusions please: This bill will not be repealed. Even if Republicans scored a 1994 style landslide in November, how many votes could we muster to re-open the “doughnut hole” and charge seniors more for prescription drugs? How many votes to re-allow insurers to rescind policies when they discover a pre-existing condition? How many votes to banish 25 year olds from their parents’ insurance coverage? And even if the votes were there – would President Obama sign such a repeal?
We followed the most radical voices in the party and the movement, and they led us to abject and irreversible defeat.
There were leaders who knew better, who would have liked to deal. But they were trapped. Conservative talkers on Fox and talk radio had whipped the Republican voting base into such a frenzy that deal-making was rendered impossible. How do you negotiate with somebody who wants to murder your grandmother? Or – more exactly – with somebody whom your voters have been persuaded to believe wants to murder their grandmother?
Well, one can only hope. Abject and irreversible defeat is exactly what they deserve, and exactly what would be best for our country. But we'll see. So far, the right-wing seems almost giddy with anticipation of what political gold this could be, if they just keep up a united front. Certainly, they all seem to be frothing at the mouth about it.
Edit: Here's a follow-up post on the health care reform bill.
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