Jim Pinkerton and I have been going back and forth over my criticism of Bobby Jindal’s health care op-ed in the Washington Post earlier this week. Today he has a new post up in which he acknowledges that conservatives and libertarians often agree on economic issues, but writes that the Republican Party is more open to a larger role for the federal government. On that point, he’ll get no argument from me. However, just because Republicans have embraced policies such as the Medicare prescription drug plan, it doesn’t mean that doing so has proven either successful practical politics or good governance.
When it was being debated, Republican supporters of the drug bill made many of the same arguments that Pinkerton is making now. They thought it would help the party close the gap on health care with Democrats and overcome the image of the party as a bunch of scrooges. But it did nothing of the sort. In the 2000 presidential election, those who identified health care as their most important issue voted for Al Gore by a 64 percent to 33 percent margin over George W. Bush, according to exit polls. Yet despite signing the prescription drug bill during his first term, in the 2004 election, Bush actually fared worse among health care voters — which John Kerry won 77 percent to 23 percent.
Meanwhile, the bill added $9.4 trillion to our long-term entitlement obligations and helped cement the image of Republicans as a fiscally irresponsible. While this wasn’t the primary basis for GOP defeats in 2006 and 2008, it did reinforce the broader critique of Republicans as incompetent.
I’ve written about this more extensively in the past, but a big problem we face is that because many conservatives have neglected health care as an issue, it has created a sense of desperation that allows a Jindal or Romney to come out with a proposal that substantially embraces the Democratic vision for reform, and get credit for being a Republican saying something about the issue. But I, for one, refuse to accept this false choice between indifference or acquiescence on the most important domestic issue of our time. That’s why, in addition to criticizing Democratic proposals, I’ve written a lot about how to improve the health care system by expanding individual liberty (see here, here, here, here, and here). I’d much rather spend my time trying to argue in favor of such ideas — win or lose — than handing out gold stars to any Republican who shows up to the debate.
