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June 07, 2013 1:29 PM Behind the Obamacare Derangement Syndrome

By Ed Kilgore

At TNR today, Noam Scheiber looks at the deep investment Republican pols and conservative scribblers and gabbers seem to have in the failure of the Affordable Care Act of 2010, and sees a concentration of the biases we have all called the Obama Derangement Syndrome on this one issue.

To Scheiber, this can only be “derangement,” because it makes little sense; in his view, no matter how badly the implementation of Obamacare goes, it won’t affect most people and will give most of those it does affect something they didn’t have before.

But I’d offer three rational—if empirically dubious—motivations for the conservative obsession with killing or disabling the ACA:

(1) They view it as a turning point in American political history. Remember that most conservative activists, and certainly the “constitutional conservatives” who are dominant in their ranks—view the mid-to-late late twentieth century as one long hellwards slide away from everything that made American great, with the exception of the false spring of the Reagan years. They’re not happy with the existence of Medicare and Medicaid. And this is why even those who are ready to live with Obamacare are inclined to use it as a way to undermine the public role in health care more generally. That’s the big contest, and the success or failure of Obamacare will determine which way the arrow points going forward.

(2) They think they’re on the right side of public opinion as well as of history. It’s sometimes hard to remember how rarely Republicans, even when they are winning elections, are on the positive side of public opinion on a specific issue. The polls showing consistent majorities of the public disliking Obamacare is a deeply satisfying phenomenon for the Right. It’s so satisfying, indeed, that conservatives to a remarkable extent almost never come to grips with the evidence that a sizable chunk of Obamacare opponents support a larger government role in health care—such as the socialist abomination of Medicare For All—and that an even larger chunk seem to favor nearly all the individual elements of the ACA. Never mind: consistent majorities oppose Obama’s namesake accomplishment, and that’s a firm rock on which all other political strategies and messages can and must depend.

(3) They’re very worried it will eventually seduce some Americans into greater dependence on government. Scheiber finds derangement in the fact that although conservatives all say they think Obamacare will fail, they are acting as though it must be stopped immediately lest it succeed. I find this pretty natural given the typical conservative attitude towards the psychology of what they consider socialism: it doesn’t work, it isn’t generally popular, but for the weak of mind and spirit, it’s highly addictive. In particular, those people—whether we are talking about the working poor who would obtain Medicaid under the original ACA framework, or those higher on the income scale who would get access to affordable and non-deniable health insurance—the parasites and moral lepers who haunt the American conservative vision of their fellow-citizens, would form additional bonds with Leviathan that would be difficult to dissolve.

Now I find all those motives for obsessing about Obamacare pretty messed up on multiple grounds. But it’s not all that irrational. As Ayn Rand used to always say: “Contradictions do not exist. Whenever you think you are facing a contradiction, check your premises.” Given their premises about government and their very low opinion of their own country, the Obamacare Derangement Syndrome makes abundant sense for conservatives.

Ed Kilgore is a contributing writer to the Washington Monthly. He is managing editor for The Democratic Strategist and a senior fellow at the Progressive Policy Institute. Find him on Twitter: @ed_kilgore.

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