Tevi Troy: Health Care ... A Two-Decade Blunder





[Tevi Troy is a visiting senior fellow at the Hudson ­Institute and was deputy secretary of the U.S. Department of Health and Human Services from 2007 to 2009. Julius Krein assisted with the research for this article.]

In 1991 the political world was rocked by the unlikeliest of victories. Harris Wofford, a former aide for John F. Kennedy, upset two-term Republican Governor Richard Thornburgh in a special election to fill the seat of the late Pennsylvania Senator John Heinz. Wofford was guided to his victory by a little-known campaign manager named James Carville, who told him to make a bold and unequivocal case for “universal health care.” Wofford’s underdog victory left the GOP shell-shocked.

Fast-forward 19 years: it is the Democrats who are now faced with divining the results of another underdog’s victory. In January, a little-known state senator named Scott Brown defeated Massachusetts Attorney General Martha Coakley in a special election for the United States Senate. Universal health care was once again on center stage. This time around, though, the Republican seized on widespread antipathy to what has come to be seen as an incoherent Democratic scheme for an unworkable federal takeover of health care.

The unlikely victory not only defied the odds of a Republican winning in Democrat-owned Massachusetts; Brown’s ascent also put him in the storied seat of the liberal lion Ted Kennedy. Before Brown, no Massachusetts Republican had won a Senate election since Edward Brooke in 1972; no Republican presidential candidate had secured Massachusetts’s electoral votes since Ronald Reagan in 1984; even more striking, the Bay State had not sent any Republicans to the House of Representatives since 1996. However, beyond the mere realization of an improbable data point, this special election called into question much of the received political wisdom of the past 20 years. Brown’s victory directly contradicted the liberal claims that Democrats own the health-care issue and that comprehensive reform is popular. As a candidate, Brown ran on a platform promising to serve as the health-care roadblock he instantly embodied on being elected.

In fact, the Brown election can be seen as the closing of the door on a two-decade era in which Democrats, Republicans, and most of the political class came to believe that the Democrats possessed an inherent electoral advantage on the health-care issue. The history of the past 20 years reveals two Democratic presidencies, first Bill Clinton’s and now Barack Obama’s, upended by health care, whereas a single administration—that of a Republican, George W. Bush—benefited from it. In 2004, Bush was able to secure a narrow re-election victory in part because of his success in securing a form of targeted health-care reform through the creation of a Medicare prescription-drug benefit.

The combination of Democratic wishful thinking and an American electorate suspicious of the intentions of those pushing relentlessly for an ever greater government involvement in health care has proved a ballot-box disaster for Democrats. How did this happen? And why?..

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