Conditions in the country have changed for the worse since the last try at health care reform, with much greater income inequality now and with people increasingly aware of their own economic vulnerability.
But the Republican strategy for defeating reform has stayed much the same as 15 years ago, because their analysis of what a successful Democratic plan for universal coverage will mean to the Republican Party politically hasn't changed either:
Health care reform remains popular in principle. And the Democratic Party has the votes...
Any Republican urge to negotiate a "least bad" compromise with the Democrats, and thereby gain momentary public credit for helping the president "do something" about health care, should also be resisted...
But the...proposal is also a serious political threat to the Republican Party. Republicans must therefore clearly understand the political strategy implicit in the ...plan--and then adopt an aggressive and uncompromising counterstrategy designed to delegitimize the proposal and defeat its partisan purpose...
A large majority of Americans consistently reports that it believes our country's health care system, writ large, to be dysfunctional...
"Health care will prove to be an enormously healthy project for [the president]... and for the Democratic Party.".. [T]he long-term political effects of a successful...health care bill will be even worse--much worse. It will relegitimize middle-class dependence for "security" on government spending and regulation. It will revive the reputation of the party that spends and regulates, the Democrats, as the generous protector of middle-class interests. And it will at the same time strike a punishing blow against Republican claims to defend the middle class by restraining government.
That strategy memo from 1994 is still their playbook, and the stakes are even higher, because so many people are so much more desperate and without proper health care now.
What I wonder is if real reform passes, what are the Republicans going to say to their followers? Don't sign up for guaranteed health care coverage? Insist on your right to pay ever-rising premiums and co-pays? Refuse to not be kicked out of your plan by your insurance provider when you get sick and need to make a claim?
What's going to happen to the Republicans who opposed health care reform once the people they duped into fearing universal coverage realize that instead they're benefiting with increased security and lower rates in a re-regulated market? Will Fox News and the Republicans be able to convince the teabaggers and their fellow travelers that in fact they're worse off? Or will the game finally be up for them, no matter how much they spin, at least on this particular topic?