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Aligning incentives

Why are the Republicans in Congress so uniform in their opposition to any health-care reform bill? I can't believe that every single Republican actually has implacable objections on principle to every single proposal that's been brought forward, and not one of them has any ideas worth bringing forward themselves. Realistically, we all know it's about 2012: they want to see Obama fail on his highest-priority item, so they can put a Republican in the White House in 2012.

What does "fail" mean? It could mean "fail to pass anything," but that's unlikely: the Democrats have enough votes to pass something, however wimpy, that calls itself "health care reform". Which leaves "pass something that doesn't work." If they can't block the bill entirely, they have an incentive to make the bill as ineffective and inefficient as possible. Which puts the Republican party directly at odds with the American people, who -- although far from agreement on how to fix health care -- have a strong and unanimous interest in health care reform that works.

I presume at least some of the Republicans in Congress have recognized this conflict of interest, and are serious enough public servants to be uncomfortable with it. So how else could this play out?

As long as the bill has zero Republican support, it's a Democratic bill and the R's have every incentive to see it fail, so the bill will continue to have zero Republican support, in a vicious circle. And the Republican party's interests will still be aligned against the interests of the American people.

But what if it weren't a "Democratic bill"? What if a significant number of Republicans in Congress actually participated in constructing a health care bill, and seriously considered voting for it, rather than just saying "I object! I object!"? The R's would then be on the same side as the American people -- disagreeing about details of implementation, but at least in favor of finding something that works.

I think that's what Obama tried to do from the start, expressing his open-mindedness and willingness to compromise. Unfortunately, months of compromise have yet to produce a single Republican vote; the Republican party has made the strategic decision that they're better off opposing anything that Obama proposes, no matter how much it might be in line with their own principles or the interests of the American people. Is there any chance of this changing now that we're in the reconciliation phase?

For that matter, what are the interests of right-wing Democrats? They're in the same party as the President, so they do have an incentive to come up with something that works, but they also have an incentive to throw their weight around and grab goodies for their own constituents, be they pro-lifers who are otherwise moderate and might conceivably vote for a Democrat, or insurance-company employees (coughConnecticutcough) who want to see the insurance industry protected and coddled at taxpayer expense, or probably-unConstitutional single-state exemptions. And they can get this stuff because they have so much leverage: if the bill had a handful of Republican votes, they would lose a lot of that leverage, and the resulting bill would be more likely to actually work (and thus be good for those few R's who had voted for it, although not for the R's 2012 Presidential candidate).