Saturday, August 8, 2009

Healthcare Reform: Latest Battle Of The Culture Wars

I haven't been blogging much about healthcare reform because it has felt overwhelming. It's an all-or-nothing proposition. Part of my feeling has been that this healthcare reform bill will set the stage for other reform efforts. This establishes the framework, but there will be lots of opportunities for changes later on.

Now that we are in the final stages, it feels like a good time to step up to the plate. The policy details are out there and are being hashed out in Congress, mostly the Senate Finance Committee at this point.

Outside of Washington, the debate is getting nasty, with some very loud protesters from the right shouting down their opponents. The right is arguing that these people are just upset. Andrew Sullivan noted the lack of attention to detail in these protests:

Look: if these people were yelling: "End the employer tax break!" or "More Cost-Controls!" or "Malpractice Reform!" I'd be more sympathetic. But this is blind panic and rage.
The protesters don't care about the policy details of healthcare reform because for them, this is not about healthcare reform. This is the latest battle of the culture wars.

Conservatives have lost just about every battle of the culture wars since the 1960's. They lost the battle over civil rights; a black man is now president. They lost the battle over feminism; a woman was a major-party candidate for president. They are losing the battle over immigration and assimilation; a Hispanic woman was just confirmed for the Supreme Court. They have lost the battle over abortion. They have lost the battle over separation of church and state, particularly in the classroom. They have lost the battle over gay rights, and, although they have won most of the battles over gay marriage, they will lose that battle over the long term. They have lost the battle over traditional family structure and sex in general. They have lost the battle over basic cultural norms. They have lost the battle over environmentalism.

About the only battles conservatives have won have been over gun control, crime, capitalism vs. socialism/communism, taxes, and lower regulation. But Democrats have largely given up trying to win the gun control debate, crime is down, and no one has cared about the capitalism/communism divide for years. Conservatives are still winning the battle over taxes, but it's turning out to be a Pyrrhic victory, as deficits are soaring and states can't balance their budgets. Lower regulation led to a loosening of standards, which allowed financial predators to take advantage of too many consumers, and wreaked havoc with financial institutions. Conservatives lost the foreign policy culture wars - diplomacy vs. "peace through strength" when Bush & Co. completely botched Iraq. There's still free trade, but that's not popular with anyone right now.

This is why the healthcare debate is so heated. This is not about healthcare. When conservatives scream about "government," they are screaming about liberals and what they feel is liberal control of government. Of course, since liberals actually believe in making government work properly, conservatives are justified in feeling that liberals have more influence over government. Funny how that works - people who take something seriously and want to improve it tend to have more faith in it.

Conservatives feel besieged because they have lost the culture wars on so many fronts. William F. Buckley famously said that the purpose of conservatism was to stand athwart history and yell "Stop!" But of course history doesn't stop, and to pretend otherwise is to set yourself up for constant disappointment.

Several commentators have pointed out the irony of older people, who are presumably on Medicare, a successful government medical program, protesting "government takeover of healthcare." They are not protesting government takeover of healthcare. They are protesting government, period. They are channeling years of frustration at losing so much ground to liberals in so many aspects of life in general. Years and years of built-up vitriol is spewing out over this one issue.

It doesn't help that conservatives haven't had a successful president since Reagan. They're frustrated that W. was such a failure, but they can't take their frustration out on him or the GOP, so they take it out on Obama.

It also doesn't help that so many conservative policies have failed. Cutting taxes is supposed to lead to higher economic growth, which therefore makes up for the taxes lost when they are cut. That's the original justification of supply-side economics, and it has been a miserable failure. Nation-building in Iraq? Uh, no.

The one thing that might make a difference for conservatives, that might make it easier for them to be civil when engaging in the debate about healthcare, would be if they had any good alternatives. But they don't. This just adds to the feeling of helplessness. It's impossible to deny that healthcare costs are spiraling out of control, particularly when the victims are so many business owners. But who are conservatives going to use as the target for their anger? Drug companies? Insurance companies? Those are supposed to be examples of the free market at work. They can vent at lawyers, a key Democrat constituency, and their penchant for suing for malpractice, but even taking on that won't solve every part of the problem with rising healthcare costs.

So they invent reasons to be angry. Sarah Palin makes the incredibly bizarre - even for her - claim that Obama's plan will result in government bureaucrats euthanizing her Down's syndrome baby. This is beyond ludicrous, but she apparently believes it. This has no relation whatsoever to reality. None. But this debate is no longer about reality for Sarah Palin and other conservatives. It's about trying to retain some shred of dignity as liberals win yet another victory.

The solution, and I'm sure Obama knows this, is to stay calm and cool. Let them freak out. Let them make fools of themselves. At some point a healthcare reform bill will pass. It won't be perfect. Lots of liberals will bemoan the lack of some feature or other. But it will pass, it will start to change how we deal with healthcare in this country, and then we will start to debate about how to change it.

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