Opinion: The Mythical Middle Ground on Health Care

(Feb. 25) -- Today, Republicans and Democrats are coming together for President Obama's much-hyped bipartisan health care summit. While health care will certainly be on top of the agenda, it's unlikely that much bipartisanship will be evident.

For all the voices in Washington calling for a bipartisan solution to health care reform, there is a rather large problem – Republicans aren't all that interested in compromise. Before one dismisses this as a partisan rant, the Republican position is actually quite rational and befitting conservative ideology.

Strenuously opposing the Democrats' policy proposals has reaped significant political rewards for the party.

In 1994, stopping Bill Clinton's agenda in its tracks helped Republicans regain control of the House and Senate. Doing the same today has revived the party's fortunes and given it an outside chance of repeating the feat this year. What possible political benefit would Republicans gain from helping the president pass the prize of his domestic policy agenda?

But the GOP position is about more than politics. Ideologically conservatives reject the idea that stands at the heart of the Democratic plan -- namely, that government has an affirmative role to play in providing health care to its citizens. (See, for example, Rep. John Boehner's AOL News op-ed.)

For example, instead of proposing a comprehensive plan, the GOP has offered a set of four benchmarks: allowing insurers to sell coverage across state lines, enacting tort reform, giving states waivers to design their own systems and creating health exchanges. A House Republican budget proposal would give vouchers to seniors that would allow them to buy coverage on the private market.

As health care blogger Ezra Klein points out, elements of each of these measures are in the Senate's health care legislation. But none of these provisions would solve America's health care crisis or cover the millions of uninsured -- a fact that Republicans freely admit.

Democrats argue that to reform the health care system a comprehensive solution and, perhaps above all, an active role for the federal government in subsidizing care and regulating insurance companies is essential. Yet, here is the line Republicans have no interest in crossing. They simply won't support any health care reform effort that involves a more significant role for government, and Democrats won't support one that doesn't. And thus, the two parties are at an unbridgeable impasse.

In any case, if Republicans had any real interest in health care reform, they would have enacted it sometime between 2002 and 2006, when President Bush was in the White House and they controlled both houses of Congress. The fact that they didn't is telling.

So, in an odd way, President Obama's effort to reach out to the GOP is vaguely discourteous to Republicans. They oppose Obama's policies on ideological grounds; they disagree vehemently with the idea of expanding government's reach. Trying to get them to sign on to a health care deal that would satisfy his principles is the political equivalent of trying to stick a square peg into a round hole. It's simply not going to happen.

The president and his party can and should pass health care reform -- with or without GOP support -- and then the country can debate the question of whether this was the right thing to do in the next election.

There is a fundamental divide between the two parties on the role of government, one that has grown even wider in recent years. Better to debate those two visions on the campaign trail than search for some mythic and elusive middle ground that is impossible to attain in the face of irreconcilable ideologies.

Michael Cohen writes on politics and national security. He is the author of "Live From the Campaign Trail: The Greatest Presidential Campaign Speeches of the 20th Century and How They Shaped Modern America." He blogs at democracyarsenal.org. Follow him on Twitter at @speechboy71.


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