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Posted on August 1, 2013 at 9:52 PM

Stanley B. Greenberg wrote a nice piece in The New Republic about “Obamacare”:

His main point is what a rotten job Obama has done, and continues to do, in telling the American public about what ought to be one of the signal achievements of his administration. My point in mentioning the article is slightly different. I want to ask what would have to happen, including but not restricted to Obama somehow becoming a better salesperson, for the GOP actually to suffer as a result of their vicious opposition to the Affordable Care Act. I am thinking of a wakeup call similar to what the GOP seems to have had as a result of realizing how badly they shot themselves in the foot in the 2012 elections through their opposition to immigration reform. Will smarter members of the Republican Party ever have similar regrets about their trashing of health reform?

The answer, I suggest tentatively, is that such regrets will be a long time coming precisely because the Affordable Care Act implicates economism in a way that other issues like immigration reform don’t. The GOP did not have to overcome its addiction to economism to decide that it had a problem with the Hispanic vote—but only a real moment of awakening regarding economism would suffice before similar enlightenment would dawn on health reform.

Greenberg is on to this, even though he does not foreground the issue: “The conservatives are right. Health care reform is the biggest use of government to reshape major parts of the economy, regulate business, create a new form of social insurance, restructure the distribution of public health, redistribute wealth and benefits, and create new rights since the passage of Medicare and Medicaid under Lyndon Johnson and Social Security under Franklin Roosevelt.”

Translation: Republicans are not simply channeling their vicious opposition to anything with Obama’s fingerprints on it when they attack the Affordable Care Act. As smart analysts noted from the get-go, this is the biggest government redistribution of wealth in an era when both Republicans and “new” Democrats vie with each other to regard income inequality as a part of the natural landscape and the Divine plan. Republicans are hardly overreacting when they see this as fundamentally attacking all that they hold dear. No wonder Greenberg characterizes the Affordable Care Act as “once-in-a-generation liberal reform.”

To decide that there’s no mileage to be had in continuing to attack “Obamacare,” the GOP would have to accept a number of things. They would have to buy the idea that (as smart economists told them half a century ago) health care is a market failure—that no amount of application of the “free market” to health care will yield a decent and fair system of financing. They would have to agree that there’s a positive role for government intervention in the health system, and that some forms of government regulation are essential. They’d have to accept that the only way to assure access to health care both equitably and efficiently is for the wealthy and healthy to pay more on behalf of the sick and poor.

All these ideas violate basic shibboleths of economism. You’d as soon hear the average Republican admit that as President, Ronald Reagan was overrated.

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