As a non-Movement Conservative lost in a political era in American history that has largely been dominated by the Movement Conservative Right, I find watching what I see as Conservative on Conservative political violence to be utterly fascinating. We have reached the bewildering point where what was once baseline Movement Conservative policy is being excoriated by Movement Conservative Justices because non-Movement Conservatives embraced them, thus making them "Leftist"... and like broccoli. (Eye roll.) While I might have strongly disagreed with various things that might have been put into or left out of the current law, or with the stragetic thinking and political calculations behind why and how they were adopted or dropped in the sad nightmarish process of crafting the bill in the first place, what I simply cannot question is the good faith of the vast majority of the reformers. It was clearly calculated that by adopting these policies and positions that the reformers had thought that they had found a way of ensuring that what was passed would then be essentially unimpeachable by rightwing jurists. The ultimate expression of how tragic and misguided it is to assume good faith where all evidence points to none existing? Maybe. but the bad faith and intellectual dishonesty behind the ACA attacks are breathtaking.
The Individual Mandate was fundamentally developed by a conservative economist named Mark Pauly. He designed the basic concept and mapped out its features as an alternative to a single payer system, and it was later embraced by the Heritage Foundation and the American Enterprise Institute as an alternative to the employer mandate that was at the core of the Clinton Healthcare Reform effort. “We did it because we were concerned about the specter of single-payer insurance, which isn’t market-oriented," Pauly said to Ezra Klein in 2011.
Ezra graciously avoided asking Mr. Pauly bluntly why he hated both America and freedom.
Paul Krugman didn't scribble down the Individual Mandate while waiting in a slow line to buy a kewl hemp hoodie and a mad Blues Traveler poster at some early 1990's era Hordefest concert.
The Individual Mandate and the concept of the Exchanges were both Movement Conservative ideas, and if a President John McCain has passed ObamaCare as it is, it wouldn't be where it is today. It would just be American law. No Broccoli to be found. Every force behind the policy that ended up being the final bill had an eye on the law that resulted being upheld. I believe that the 1990's era Republican model for reform was the base framework because nobody who backed that path could imagine that conservatives on the Supreme Court could ignore it being Movement Conservative policy. It would have to be a process so staggeringly dishonest and one so gobsmackingly dismissive of a century of prededent that for them to even entertain the notion of doing so, and striking the law down, was just completely inconcievable. Well, when dealing with Movement Conservatism, it's only inconcievable until they do it. As I listen to the audio of the ACA defenders attempting to preserve the law, I feel a great deal of empathy for them and the probable shock and surprise that they are being greated by bad faith Tea Party and Tenther talking points from the Supreme Court bench. They believed what they believed. That there was good faith to be found and that nobody could be that intellectually dishonest.
While the Right feels more and more confident about winning the campaign to strike down the ACA, a victory over the Obama administration just might end up being one of the most totally disasterous things that Conservatives end up doing to Conservatism itself.
Should ObamaCare, AKA the ACA, be struck down by a 5-4 majority of the Roberts-led Supreme Court, the ultimate irony of the decision will be the death of Movement Conservatism's last best chance of preserving a free market-based outcome in regards to dealing with what is inevitable. This law was the game for the free marketeers. Both the Individual Mandate and the exchanges were, and are, the Right's best-case scenario for a healthcare reform outcome. The status quo that existed before the ACA is finished. It was not and is not sustainable, it was never a viable option to return to, and it will be even less so if it is returned to catastrophically by the Scalito Bunch as a 'Fuck You' to a Democratic President. Strike down the ACA and all roads lead to the eventual outcome that is adopted being adopted because of overwhelming human suffering and not because of a slow rational political debate. Suffering overwhelming all other considerations except stopping human suffering doesn't lead to one lending ones ear to concern trolling, hippy punchers, and industry lobbyists. At that point, the profit motives of the most powerful forces in heathcare delivery will not drive the debate, and the end result will not be grounded at all in both preserving the free market's role as well as providing universal access to affordable care.
And that outcome will be the Right's own fault because if they win, they only win for now, and they "win" by tearing down many of their own ideas as unconstitutional. Single Payer is not on trial here, if anything it is likely that more liberal concepts like Single Payer or the Public Option will be raised up as being lawful, but Movement Conservative created ideas to preserve the free market role in providing access to affordable healthcare, specifically designed by conservatives to avoid a public system are in the crosshairs.
The for-profit model status quo is on a pathway to the dustbin of history and nothing can ever change that. The ACA was clearly an attempt at both reforming healthcare and preserving the for-profit model at the same time while doing it. If that is "Collectivism" and "Tyranny" then the Heritage Foundation should be covered in massive murals of Soviet propaganda artwork and the American Enterprise Institute should have to call all of their future big economic position papers their five year plans. Healthy people paying in in large enough numbers to cover all the costs of the sick's care and creating enough of a revenue stream while doing it so that companies can turn a profit too at the same time is not "Socialism", it's capitalism meeting basic math with an eye on a sustainability model, nothing grounded in radical leftist thinking. They kill this at their peril. From here, there is absolutely no policy or political road to anything more fundamentally free market conservative than the ACA, because there is simply no chance that the status quo is going to remain as it is. Conservatives seeing 1990's era Movement Conservative ideas as radical leftism because the black President they hate more than Clinton, Carter, and Kennedy combined is a remarkable movement wide attempt at scoring an own-goal as I have seen in twenty years. Its just tragic that they would be screwing millions to do it if they actually win.
There is a strange phenomena that repeatedly comes up in regards to Movement Conservatives and their staunch opposition to non-Movement Conservative policy, and that is the point when conservatives start acting as if killing an ongoing attempt at finding a policy solution to a real problem is somehow the same thing as eliminating the real problem itself. You can see this in HCR in the lack of any "Replace" policy to go along with the firey "Repeal and Replace" rhetoric. Nada. Nothing. Zippo. That is what you get for the "Replace" part of the equasion if the ACA is crippled or struck down. If you combine that with the gleeful middle fingerism going along with the fight going on before the Supreme Court, and the reality that the status quo has got to go, they are just begging for a longterm policy outcome that is both a thousand times worse than "ObamaCare" in hindsight, and a far, far less conciliatory Democratic Party that they have ever been dealing with in the last few decades. Truth be told, I hope the ACA stands up, because although I think that there is going to need to be a reform for the reform someday, it's better than leaving millions out to dry for probably years to, more likely, decades. While I support single payer, I don't want the ACA to be struck down because an ideological solution that is more to my liking is going to take a long time to get in place and there is real suffering to be addressed now.
It's just that it's hard not to marvel at the idea that the far Right hates Obama so much, so, so much, that they would even be willing to kill a free market based HCR law, which would be the last one they are ever going to see that embraces their ideas to this extent by any truly sane Democrat having two eyes, two ears, and half a brain. A move which would just about chart a national course longterm towards the very, very hated single payer system that the Individual Mandate was designed to permanently thwart by a conservative economist as a consequence. That's hate.
Somebody up there must like the Democratic Party, truly, because they are the luckiest bunch of trainwrecks in the world to have the GOP for opponents. First they wouldn't take 'yes' for an answer on a "Grand Bargain" that might have caused a GOP landslide in the 2012 elections, and now I'm wondering how Mark Pauly would look as Che on a black XL T-Shirt while I hope tens of millions don't get screwed over because the smartest people in the room all thought they had a surefire way to get reform by going with the free market. Christ, trickle down economics might become radioactive if Obama hinted 80's era Republican economists had some ideas he wanted to mill over. No matter what happens next, I hope Barack Obama takes out every last bit of this ACA fight out on Mitt Romney until Willard wishes that Santorum had won the nomination.