LIMITED PARALLELS…. The Atlantic‘s Derek Thompson has an item today comparing ongoing health care reform efforts to one of George W. Bush’s more ambitious domestic policy initiatives.
The prevailing concern among liberals is that health care reform in 2008 will follow in the footsteps of the 1993 debacle. This is a legitimate concern, and health care reformists would be wise to draw lessons from the Clintons’ failure, but we don’t need to reach back the 1990s for allusions to failed entitlement reform. Beleaguered Republicans could always sink health reform the way beleaguered 2005 Democrats torpedoed Social Security privatization: Paint the other side as radical conspirators against America.
As Thompson sees it, Bush’s detractors criticized Social Security “reform” by explaining that it was really just privatization by a different name. The plan, in other words, was more nefarious than officials were willing to admit. Likewise, Obama’s detractors now insist that overhauling the health care system is really just a secret effort to impose a single-payer system.
In 2005, it was progressive voices like Paul Krugman who tried to expose Bush’s Social Security scheme for what it was really was. In 2009, it’s conservative voices like George Will who insist the health care system is fine and does not need to be reformed.
Krugman then (like Will now) railed against a radical plan to give an entitlement system a facelift and beat the conspiracy drum to alert readers that the government was’t [sic] being honest about their plans. In both cases, dramatic entitlement reform wasn’t necessary, but it was a microcosm of the perverse ideology that ruled the White House and sought to change the face of America forever.
There’s a lot wrong with this comparison.
First, the Krugman and Will arguments may feature similarities in style, but that doesn’t mean they’re of equal validity. If we look at the substance, instead of the rhetorical commonalities, Krugman was right about Social Security and the effects of privatization. Will’s health care pitch (tax credits for everyone) quickly falls apart.
Second, the underlying needs are polar opposites. Social Security, as was noted at the time, was not facing a crisis. The status quo on heath care is completely untenable and serves as a brutal drag on the national economy. It costs too much, covers too few, and keeps getting worse.
Third, while Bush went out of his way to avoid letting voters know the details of his Social Security ideas while running for national office, Obama made health care one of the centerpieces of his national campaign. What’s more, while the public was deeply skeptical of privatization, there’s strong national support for reforming health care in general, and including a public option, in specific.
Granted, we dealing with presidents, fresh off a campaign victory, working with a Congress led by their party, on an ambitious domestic policy matter. But I’m afraid the similarities pretty much end there.