It would be difficult to exaggerate the extent to which the right outgunned the left during the debate over the Clinton health care plan in 1993 and 1994.
Just a days after Clinton formally delivered his plan to Congress, strategist Bill Kristol delivered his now-famous memo urging Republicans to oppose any universal coverage proposal rather than work on compromise. It quickly became the Republican leadership strategy, one they carried out in close coordination with an array of health industry groups.
Meanwhile, Democrats squabbled among themselves and the big interest groups expected to support reform--labor and retirees--largely sat on the sidelines until it was too late. (Labor was still angry about Clinton's embrace of the North American Free Trade Agreement, which he'd just finished pushing over their objections; the AARP held off a big push because members had gotten spooked over prospective Medicare cuts.)
In short, the right had more money, more unity, and more organization.
So far, 2009 is shaping up rather differently. And that's good news for reformers. President Obama and key congressional leaders are working hand in hand, as they have been for months, on what is-- in the broad sense--a commonly shared vision for health reform. Liberal interest groups are on board, too. Led by groups like Health Care for America Now, they have money, a ground presence, plus a coordinated strategy that dovetails perfeclty with what's happening in Washington.
And the Republicans? They are a bit behind, as Carrie Budoff Brown details in a must-read story for Politco:
There’s no Republican plan yet. No Republicans leading the charge who have coalesced the party behind them. Their message is still vague and unformed. Their natural allies among insurers, drug makers and doctors remain at the negotiating table with the Democrats. ...
“I thought we would have been much farther along than we are,” said Rep. Michael Burgess (R-Texas), a physician who started the Health Care Caucus this year and wrote a 29-page “primer” for his colleagues. “Senator [John] McCain, for all his faults, had a program a year ago. People became pretty comfortable with McCain carrying the load on that and when he wasn’t successful in November, it left a big void.”
... anxiety is setting in among some Republicans that they aren’t ready.
“That is a definite concern,” said an aide to a senior congressional Republican, who spoke on the condition of anonymity to talk candidly about his party. “There is catch-up in terms of us talking about it in public. There is a good core of ideas, but we haven’t talked about the issue as much as Democrats. We are playing catch up. We are running against the wind. They have a lot of momentum.”
During the grueling primary campaign, when Obama and Hillary Clinton slugged it over the individual mandate, many experts speculated that the debate would end up undermining reform--by forcing the candidates to put forward details prematurely and highlighting the less appealing aspects of reform legislation. And, to some extent, that undoubtedly happened.
But it's also clear that the debate prepared Democrats for what's happening now. At all levels, from grassroots organizers right up to the president himself, they've worked through the essential arguments and developed a sense of how to win them.
It helps that the campaign debate grew out of an extended conversation among liberals that had been taking place for many years, dating back to the aftermath of the Clinton failure. Health care re-emerged as a front-burner political issue only in the last two or three years. But policy experts and strategists on the left have been cogitating on how to craft--and how to enact--health reform for more than a decade.
By contrast, the conversation among Republicans remains far more preliminary, in part because the party's key figures just haven't been that interested.
In the Politco article, Burgess tells Budoff that Republicans had been relying on McCain to carry the party's arguments on health care. But that's a pretty devastating indictment right there. McCain is hardly a health care expert. He more or less discovered the issue of coverage and cost because he had to do so: The voters he needed were talking about it. Even then, it was clear neither he nor his supporters entirely grasped what he was proposing--or why.
None of this means Democrats are destined to win the reform fight. Once the actual details of legislation are on the table, Republicans and their allies may quickly find both unity and a good message. But I suspect they'll have a harder time doing it this year than they did last time around.
Update: Ezra weights in with some well-founded skepticism. I remain convinced the left is more organized--and the right less organized--than it was last time around. But he's right that the opposition will start to rally once actual proposals are on the table.