When it comes to blocking Barack Obama's health care plan, what is old is new for the conservative movement. Fearing a permanent Democratic majority if Bill Clinton succeeded in passing his health care reform package, Bill Kristol in 1993 famously authored a memo urging Republicans to halt it at all costs. Now in the wake of the GOP's latest blowout at the ballot box, its water carriers in right-wing think-tanks and media are calling for history to repeat itself.
In December 1993, the former Quayle chief of staff and current New York Times columnist Kristol galvanized Congressional Republicans with a private memo titled, "Defeating President Clinton's Health Care Proposal." As the American Prospect recalled in January, Kristol's war plan:

Darkly warned that a Democratic victory would save Clinton's political career, revive the politics of the welfare state, and ensure Democratic majorities far into the future. "Any Republican urge to negotiate a 'least bad' compromise with the Democrats, and thereby gain momentary public credit for helping the president 'do something' about health care, should be resisted," wrote Kristol. Republican pollster Bill McInturff advised Congressional Republicans that success in the 1994 midterm elections required "not having health care pass."

Kristol's central strategy in obstructing Clinton's success in resolving the health care crisis was simply to deny its existence. Not content to offer a "simple, green-eyeshade criticism of the president's health care plan," Kristol insisted the GOP must "kill it outright." While advocating many of the same free-market reforms later peddled by George W. Bush and John McCain (tax credits, medical savings accounts, etc.), Kristol implored his allies that "passage of the Clinton health care plan in any form would be disastrous." His prescription:

"To repeat: The president's plan would have a seriously detrimental effect on the quality of medical health care. And the president's plan is unnecessary: There is no health care crisis, and the reforms suggested above show how real problems can be directly addressed."

And so it came to pass. In the Senate, long-time health care reform supporter Bob Dole (R-KS) in early 1994 adopted Kristol's mantra:

"Our country has health care problems, but no health care crisis."

Collectively, the unbreakable GOP stonewall, successful conservative myth-making, massive interest group intervention and the Clinton administration's own political bungling doomed health care reform in 1994. That fall, the Democratic majority in the House was swept away by the Contract with America. And the rest, as they say, is history.
Fast forward 15 years and some of the right would like to see history repeat itself. Despite the continued and dramatic deterioration of the American health system, conservative voices are again calling for obstructionism at all costs.
That's the word from Michael Cannon at the Cato Institute. Parroting the think-tank's claim that Obama's health care proposal is "socialized medicine," Cannon sounded Kristol's old clarion call:

"Blocking Obama's health plan is key to GOP's survival. Ditto Baucus' health plan. And Kennedy's. And Wyden's.

Approvingly citing Norman Markowitz' assertion at PoliticalAffairs.net that "national health care [and other measures] will bring reluctant voters into the Obama coalition," Cannon fretted that "making citizens dependent on the government for their medical care can change the fates of political parties." For arch conservatives, that formula spells trouble for the GOP.
On Friday, James Pethokoukis also picked up Kristol's baton. Writing in US News, he recounted the dire warning from a Republican strategist who told him, "Let me tell you something, if Democrats take the White House and pass a big-government healthcare plan, that's it." Concerned that "creating the Obamacare Class would pull America to the left," Pethokoukis echoed Cannon's obstructionist line.
None of the above is to suggest that 2008 is necessarily the second coming of 1994. As the American Prospect's Ezra Klein described last December, the political landscape has changed markedly. If anything, the implosion on Wall Street, the mushrooming Bush recession and especially the woes of the American auto industry have changed the political calculus for health care reform. And, as I documented previously here and here, the health care crisis is far more severe now than even the jump from 37 million to 47 million uninsured would suggest:

In November 2007, research from the Economic Policy Institute showed that employer-provided health care in the United States has dropped sharply, with workplace insurance covering only 59.7% of Americans now, compared to 64.2% in 2000. And in June, a devastating new assessment from the Commonwealth Fund showed fully 25 million Americans are now "underinsured," a staggering 60 percent jump since 2003. All in all, 42% of the people in the United States under age 65 have insufficient insurance - or simply none at all.
As the New York Times reported, premiums for family health insurance have surged 78% since 2001 to over $12,000 a year. That cost explosion comes even as Americans' salaries and wages have barely moved: "inflation-adjusted median family income has dipped 2.6 percent -- or nearly $1,000 annually since 2000." It should come as no surprise that the wealthiest Americans now live 4.5 years longer than the least-well off, a startling jump from just a 2.8 year gap reported in 1982.

But for many on the right, changing circumstances for the American people requires the same response from the Republican Party. A decade and a half after stopping Clinton dead in his tracks, curing the American health care system, they still worry, could kill the GOP. And so 2009 could see a repeat of the Bill Kristol's scorched earth strategy.
George Santayana famously said, "those who cannot learn from history are condemned to repeat it." But when it comes to the current American health care debate, it would be fitting if Karl Marx of all people predicted the fate of Republican obstructionism. Historical events, he said, occur twice, first as tragedy and the second time as farce.