Health-Care Reform Could Kill the GOP

Can policy be both wise and aggressively partisan? Ask any Republican worth his salt and the answer will be an unequivocal yes. Ask a Democrat of the respectable Beltway variety and he will twist himself into a pretzel denying it.

For decades Republicans have made policy with a higher purpose in mind: to solidify the GOP base or to damage the institutions and movements aligned with the other side. One of their fondest slogans is "Defund the Left," and under that banner they have attacked labor unions and trial lawyers and tried to sever the links between the lobbying industry and the Democratic Party. Consider as well their long-cherished dreams of privatizing Social Security, which would make Wall Street, instead of Washington, the protector of our beloved seniors. Or their larger effort to demonstrate, by means of egregious misrule, that government is incapable of delivering the most basic services.

That these were all disastrous policies made no difference: The goal was to use state power to achieve lasting victory for the ideas of the right.

On the other side of the political fence, strategic moves of this kind are fairly rare. Instead, for most of my lifetime, prominent Democratic leaders have been chucking liberalism itself for the sake of immediate tactical gain.

Former President Bill Clinton, who is widely regarded as a political mastermind, may have sounded like a traditional liberal at the beginning of his term in office. But what ultimately defined his presidency was his amazing pliability on matters of principle. His most memorable innovation was "triangulating" between his own party and the right, his most famous speech declared and end to "the era of big government," his most consequential policy move was to cement the consensus on deregulation and free trade, and many of his boldest stands were taken against his own party.

The results were not pretty, either for the Democrats or for the nation.

Still, conservatives have always dreaded the day that Democrats discover (or rediscover) that there is a happy political synergy between delivering liberal economic reforms and building the liberal movement. The classic statement of this fear is a famous memo that Bill Kristol wrote in 1993, when he had just started out as a political strategist and the Clinton administration was preparing to propose some version of national health care.

"The plan should not be amended; it should be erased," Mr. Kristol advised the GOP. And not merely because Mr. Clinton's scheme was (in Mr. Kristol's view) bad policy, but because "it will revive the reputation of the party that spends and regulates, the Democrats, as the generous protector of middle-class interests."

Historian Rick Perlstein suggests that this memo is "the skeleton key to understanding modern American politics" because it opens up a fundamental conservative anxiety: "If the Democrats succeed in redistributing economic power, we're screwed."

In the Clinton years, of course, it was the Republicans who succeeded. And the Democrats' failure -- the failure to deliver national health care that is, not the act of proposing national health care -- was a crucial element, in Mr. Perlstein's view, in the Republican Revolution of 1994. Assessing the accomplishments of the "party of the people" after those first months of Clintonism, middle-class Americans were left with what? A big helping of Nafta. Mmm-mmm.

Fourteen years later, we find ourselves at the same point in the political debate, with a Democratic president-elect promising to deliver some variety of health-care reform. And, like a cuckoo emerging from a clock, Mr. Kristol's old refrain is promptly taken up by a new chorus. "Blocking Obama's Health Plan Is Key to the GOP's Survival," proclaims the headline of a November blog post by Michael F. Cannon, the libertarian Cato Institute's director of Health Policy Studies. His argument, stitched together from other blog posts, is pretty much the same as Mr. Kristol's in 1993. Any kind of national medical program would be so powerfully attractive to working-class voters that it would shift the tectonic plates of the nation's politics. Therefore, such a program must be stopped.

Liberal that I am, I support health-care reform on its merits alone. My liberal blood boils, for example, when I read that half of the personal bankruptcies in this country are brought on, in part, by medical expenses. And my liberal soul is soothed to find that an enormous majority of my fellow citizens agree, in general terms, with my views on this subject.

But it pleases me even more to think that the conservatives' nightmare of permanent defeat might come true simply if Democrats do the right thing. No, health-care reform isn't as strategically diabolical as, say, the K Street Project. It involves only the most straightforward politics: good government stepping in to heal an ancient, festering wound. But if by doing this Barack Obama also happens to nullify decades of conservative propaganda, so much the better for all of us.