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Pop Fiction

How to demagogue health care and feel good in the morning.

On the first day of the Senate Finance Committee's hearings on health care reform, Senator Jon Kyl, a fiery free-market fundamentalist, assailed reform as a "stunning assault on liberty." By day two, he had turned to the more prosaic task of reversing the bill's cuts in the Medicare budget. The elderly, Kyl fretted, "have reason to be worried that portions of this bill could affect their care." Note that neither health care experts nor even the AARP believes the cuts would hurt senior citizens. But Kyl and the Republicans have managed to outflank even the most hard-core pension-rights lobbyists.

One could muster ideological extremism to make the case that the government has no business subsidizing health insurance for people who can't get it. Alternatively, one could make the equally nutty case that Medicare should not lose a single dollar from its budget, however wasteful and inefficient it may be. But no political philosophy on earth could justify both of these fanatical positions at once. Somehow, though, the Republican Party has managed to stake out this absurd territory--Claude Pepper minus the social conscience, Milton Friedman without the small government.

Its total lack of intellectual merit aside, this odd philosophical hybrid offers the GOP maximum demagogic potential. Republicans first began to gain traction on health care during the August recess, when a series of wild rumors (death panels, for one) devoured the agenda. More recently, they have seized upon the specific fears of Medicare recipients that universal health care will come at their expense. The result is a politically potent cocktail of status quo bias, ignorance, and general apprehension.

David Frum, the Bush speechwriter turned conservative apostate, has warned that the GOP's scorched-earth tactics will ultimately make any conservative health care reform impossible. "If we win, we'll trumpet the success as a great triumph for liberty and individualism," he admitted. "Really though it will be a triumph for inertia."

Of course, there's not much fun in conceding that your side is winning over public opinion by exploiting ignorance and fear. It's far more pleasant to imagine that the people have risen up in principled revulsion against statism.

The vanguard of this fantasy movement rests at The Weekly Standard. One issue from a few weeks ago featured a cover image glorifying the town-hall protestors. Modeled after Norman Rockwell's famous Freedom of Speech painting, it depicted a heroic conservative with a copy of the Standard in his pocket. Unlike Rockwell's image, which portrayed the onlookers as fellow citizens holding their tongues in respectful disagreement, the Standard cover depicted them as hideous goons armed with brass knuckles. The corresponding editorial, unironically entitled "People Power," explained that the public had righteously stood up against elites in the name of "freedom and responsibility." The editors of Pravda would have called this package over-the-top.

Notably absent was any close analysis of the nature of opposition to health care reform, which turns out, upon inspection, not to consist of a glorious pro-capitalist proletarian uprising. The segment of the population most opposed to reform has been the elderly, who benefit from a single-payer system in Medicare. As ABC News polling director Gary Langer explains, "Among seniors, the single strongest independent predictor of opposition to reform overall, and to a public option in particular, is the sense it'll weaken Medicare." The "freedom" here is the freedom to avoid any hint of disturbance in one's government-run health care plan.

There is also the related inconvenience that opposition to health care reform appears to be closely linked to misunderstandings of health care reform. Support for reform rises when poll respondents are read details of Obama's actual plan. And the low point for reform came during August, when public belief in death panels and other misconceptions surged.

Conservatives have reacted to this awkward fact by redoubling the anti-intellectual populism championed (and embodied) by Sarah Palin. One favored technique is to imply that anything believed by a majority of the public--or even a significant minority--must be true. Palin herself defended the fear-mongering over death panels thusly: "Establishment voices dismissed that phrase, but it rang true for many Americans." Well, that settles it.

Wall Street Journal editorial page economics writer Stephen Moore recently cited a poll showing that the average American thinks half of every government dollar is wasted. This result, he gloated, shows why "Americans are so fearful of a government takeover of the health-care system." Of course, no serious estimate would support the idea that anything close to half the budget goes to waste, and Moore makes no attempt to defend it. The notion of a "government takeover" of health care is likewise fictitious.

Taken literally, Moore's observation is true: The fact that Americans believe one absurd fiction does show that they're liable to fall for another. Naturally, however, Moore inferred something else. The new right-wing populism deems the existence of a widespread belief to be sufficient proof of its veracity.

In yet another populist Standard editorial, Fred Barnes mocked Obama's claim that health care reform could reduce cost growth while providing universal coverage. The people have rejected this contention because it violates "the laws of addition and subtraction," he huffed, adding, "Does he think we're stupid?"

I don't mean to go all intellectual elite here, but the concept of expanded coverage and slower cost growth does not, in fact, violate the laws of addition and subtraction. Every other advanced country provides universal coverage, with equivalent or often better performance, at dramatically less cost. Earlier this year, a respected study by the Brookings Institution outlined proposals to expand coverage while reducing cost growth. One of the co-authors of that study, Mark McClellan, who served in the Bush administration, has praised a draft of a Senate Finance Committee bill for fulfilling the report's goals.

The short answer to your question, Mr. Barnes, is yes.

Jonathan Chait is a senior editor at The New Republic.