President Obama wants to have a fight with the Republican who will run on repealing the whole health care bill. While I'm sure some Republicans in the deep red districts will run on that platform, I doubt the bulk of the Republican party will. I don't think Obama will get the fight he claims to want. I suspect many Republicans will wisely run on repealing just the most unpopular parts, repealing the taxes, and against the very corrupt way the bill was written.
There is a history for this strategy. After the Republicans passed Medicare Part D, did Democrats run against it by saying they would repeal the whole thing? No, Democrats ran against the most unpopular parts and the clearly corrupt manner in which the bill was written. In fact, the Republicans can probably dust off every single talking point the Democrats used against Medicare Part D. All the corrupt deals Bush cut with PhRMA for the Medicare Part D bill were protected as part of Obama's deal with them for this bill.
Republicans will probably run on repealing just the deeply unpopular provisions, like the individual mandate and the tax on health insurance benefits. We know those are winning messages because Obama campaigned on them in 2008.
The GOP might call the bill a bundle of corrupt promises masquerading as reform. They can point to the sweetheart deal for drug companies, the huge subsidies given to the private insurance companies, the deal cut with the hospitals, and the special carve-out for unions. Republicans will also be able to make a big deal about the lack of promised transparency and the many other broken promises from Obama about health care.
I can even picture Republicans attacking Democrats for passing a bill that lacks “Republican solutions” like tort reform and drug re-importation. Yes Republicans can now steal the mantle of being the party that supports drug re-importation because Obama killed in on the Senate floor. Some clever Republicans in bluer districts might even run a campaign on “fixing” the bill by removing all of the Democrats’ sweetheart deals and corporate giveaways.
Will Republicans actually be able to, or want to, deliver on promises like repealing the individual mandate or allowing drug re-importation? It is very unlikely, but that is not the point. The point is that it makes for great campaign fodder.
Health care reform will not be a simple “yes” or “no” issue in the midterm elections. It will not be a purely “we must keep this bill” or “we must completely repeal this bill” fight. Republicans will attack the bill's dozens of weak points.
The only defense for a deeply compromised bill is to have it in effect so people can judge for themselves if the benefits outweigh the negatives. The problem is, the bill does not really help anyone for four years. Democrats will have almost no immediate tangible positives to point to as a justification for their votes.
Between now and 2014, Republicans will point to every big premium increase, every higher co-pay, and every spike in drug prices as proof that “Democrats failed on health care.” Fair or not, the Republicans might start placing the blame for every new problem with our health care system at the feet of Democrats.
Democrats allowed a handful of powerful special interests and conservative Democrats to kill all the most popular elements in the bill. The public option, Medicare buy-in, drug re-importation, repeal of the anti-trust exemption, cheaper drugs for Medicare with direct drug price negotiations were all removed.
This is not meant to be a doomsday prediction or a campaign manual for Republicans (they already know how to run against this bill). This is meant to be a massive warning to Democrats. All year, I have been trying to warn Democrats in Congress. They are about to commit political suicide by over-promising, under-delivering, and making themselves appear tools of the corporations ripping off regular Americans. If you say you are going to reform health care you better reform health care.
Health care reform is not unpopular because of attack campaigns against it. No amount attack commercials was able to really dent the strong support for a public option. The bill is unpopular because Democrats kept removing every popular idea from the bill. Democrats are driving themselves straight off a cliff. They need to change course. Having the President say the only thing the very unpopular bill needs to save Democrats in 2010 is a good PR campaign is not helping the party.
If Democrats insist on passing this bill, they should start by removing all the most unpopular components ripe for Republican attack. Then, Democrats need to turn around and pass additional health care measures that start helping lots of people now--not in the distant future. They need to prove right away that health care reform is a good thing for regular Americans to save themselves in 2010. Finally, in the next few months, Democrats should take all the very popular ideas removed to appease Joe Lieberman and Ben Nelson and move them through the process with reconciliation. Democrats can save themselves from this self-destruction, but, like recovering addicts, they must first admit that they have a serious problem.