Republicans are bringing notepads to a gun fight.
With the debate over the future of the nation’s health care system effectively underway, President Obama continues to show deftness in the art of political theater.
This Monday, Obama announced an agreement with unions and health care industry groups in which they pledged to reduce the projected growth of health care costs by $2 trillion over 10 years. The details about how the groups expect to achieve these savings remain a mystery. But the image of Obama flanked by the leaders of influential groups representing insurers, hospitals, doctors and pharmaceutical companies was a show of force. It was a reminder to all of those who disagree with his vision for national health care that should they stand in his way, they will be up against a juggernaut.
Obama and his Democratic allies in Congress are proceeding with a sense of urgency. Liberal activists are mobilizing. The Health Care for America Now coalition is in the midst of a $40 million campaign for national health care it launched last summer. Yet Republicans, already weak in numbers, are responding to the prospect of the most significant expansion of the role of government in the history of the United States with a whimper.
“I agree with President Obama and lawmakers on both sides of the aisle who see that the time for reforming America’s health care system is now,” Republican Sen. Mike Enzi said in a talk to the Heritage Foundation on Tuesday.
Enzi has been involved in ongoing discussions about health care legislation as the ranking member of the Health, Education, Labor, and Pensions Committee (which is chaired by Ted Kennedy), and also as a member of the Finance and Budget Committees.
While Republicans and Democrats haven’t yet started negotiations, he said that he was encouraged by early talks.
“Let me be clear: I do want to support a bipartisan health care reform bill,” he said. “I also think it’s possible to get broad bipartisan support behind such a bill.” He suggested that health care legislation could get 80 votes in the Senate.
His comments echoed recent public remarks of other Republicans who are playing a prominent role in the health care debate, Charles Grassley and Orrin Hatch. After meeting Obama for lunch last week, Grassley also floated the possibility of achieving a compromise that would garner 80 votes. And Hatch, speaking at a Kaiser Family Foundation breakfast last Thursday, expressed confidence that ongoing bipartisan talks could yield “meaningful reform” this year.
While some issues lend themselves to bipartisan compromise — such as splitting the difference on tax and spending bills — health care is much more complicated. There are very stark differences between those who look at the problems with our health care system and see a mess caused by excessive government meddling, and those who see a dysfunctional private market that can only be fixed by more government. Democrats are in the latter camp, and given they are the majority, there is no reason to believe that they would want to make meaningful sacrifices on legislation to win passage with 80 votes when they can pass what they want with 60 (or even 50, if they resort to the process of reconciliation).
When I had the opportunity, I asked Enzi to address the obvious philosophical divide.
“I wish you could be in some of the meetings I’ve been in that are far more encouraging than what you’re reading in the papers where people are taking the outside positions so they don’t have to come as quite far to the middle,” Enzi responded.
He continued, “I’m an optimist. I think you have to be to work in this job.”
Yet while Enzi expressed confidence in his ability to strike a deal with Democrats, he was dismissive of the idea that fellow Republicans could agree amongst themselves on an alternative proposal.
“The main reason is that Republicans are very independent people,” he explained. “That’s one of the problems we have with our messaging. We’re so independent and creative that we don’t like to take the same message that somebody used on the floor and repeat it.…We prefer to be independent and have a lot of ideas, so consequently when you try to bring people together for a plan, out of the 40 of us, you’d be lucky to get 20.”
He applauded ideas presented by Republican Sens. Tom Coburn and Richard Burr, but cautioned that they shouldn’t be seen as an alternative.
The major fault line that is emerging between Republicans and Democrats is over the creation of a new government-run plan modeled after Medicare that would be offered alongside private insurance plans on a government-run and regulated national insurance exchange. Such a plan could shift 119 million Americans from private to government insurance, according to a recent study by the Lewin Group, and thus put the country on the path to a full government takeover of the medical system.
Enzi insisted that regardless of their public statements in support of such an approach, privately, Democrats are “backing away” from the idea, “or holding it out there as something to trade in the future.”
Enzi, along with Grassley and Hatch, have all come out strongly opposed to a government-run plan, meaning that if Democrats go ahead with it, bipartisan reform will fall by the wayside.
If that happens, perhaps Republicans will unite around a message and scramble to produce an alternative. The problem is, by that point, it will be far too late.