David Frum

09.30.12

A Conservative Defense of Obamacare... from an AEI Scholar

Maybe 2012 will be the world's end after all. As David tweeted, "Prague spring: an AEI fellow defends Obamacare in NYT - and keeps his job (so far)."

That AEI fellow is J.D. Kleinke, and his defense pulls few punches.

Perhaps the clearest indication of the conservative economic values underlying the act is its reception by many Democrats. The plan has few champions on the left precisely because it is not a government takeover of health care. It is not a single-payer system, nor “Medicare for all”; it does not include a “public option,” a health plan offered by a federal insurer. It is a ratification of market ideas, modified to address problems unique to health insurance.

Mr. Obama’s plan, which should be a darling of the right for these principles, was abandoned not for its content, but rather for politics. Neither side is blameless here. The White House could not have been more ham-fisted in the way it rammed the bill through Congress. The Republicans in the House and Senate lashed back with a vengeance, sifting through the legislative colossus for boogeymen like “death panels,” and when they could not find things sufficiently alarmist, they simply invented them.

Clear away all the demagogy and scare tactics, and Obamacare is, at its core, Romneycare across state lines. But today’s Republicans dare not own anything built on principles of economic conservatism, if it also protects one of the four horsemen of the social conservatives’ apocalypse: coverage for the full spectrum of women’s reproductive health, from birth control to abortion.

Social conservatives’ hostility to the health care act is a natural corollary to their broader agenda of controlling women’s bodies. These are not the objections of traditional “conservatives,” but of agitators for prying, invasive government — the very things they project, erroneously, onto the workings of the president’s plan. Decrying the legislation for interfering in the doctor-patient relationship, while seeking to pass grossly intrusive laws involving the OB-GYN-patient relationship, is one of the more bizarre disconnects in American politics.

Obamacare draws fire from this segment of “conservatives” because it fortifies the other side in their holy war. Coverage for birth control and abortion has not been introduced by the law; but it has been neutralized economically across all health plans, as part of the plan’s systemic effort to streamline fragmented health insurance markets and coverage.

The real problem with the health care plan — for Mr. Romney and the Republicans in general — is that political credit for it goes to Mr. Obama. Now, Mr. Romney is in a terrible fix trying to spin his way out of this paradox and tear down something he knows is right — something for which he ought to be taking great political credit of his own.

I would note that the potshot at social conservatives will probably ensure this article receives a similar reception from the right as Jon Hunstman in this cycle's primaries. You don't insult your base and expect it to respond with enthusiasm.

But I digress. It is stunning to see this appear in a signed statement from someone who works at an institute so dedicated to assailing Obamacare.