Conservatives object loudly to the health care reform plans currently in the works in Congress. But we're not hearing so much about what conservatives would do themselves to reform health care, beyond some vague rhetoric about "market-based" or "consumer-driven" health care, whatever that means.
It is not true that conservatives have no ideas about health care reform, however. I've been investigating the health care reform proposals cranked out by the big conservative think tanks, and they have lots of ideas. So far I have explained health care policies from The Manhattan Institute and the Cato Institute, both advocates of "consumer-driven" or "market-driven health care."
To recap: The basic idea behind the various "consumer-driven" plans touted by the Manhattan and Cato institutes is that by cutting back (or even eliminating) current government health care programs like Medicare and SCHIP, phasing out health insurance as an employee benefit, and driving everyone into the private insurance market, the "free market" will naturally drive down costs. For example, because health care consumers (e.g., patients) will comparison shop for the best insurance policies, or have more "skin in the game" by taking more responsibility for paying medical bills, competition will create a leaner, meaner health care market. Or something like that.
I think conservatives are being less than aggressive about promoting these ideas because they know most Americans would object to ending employee health care benefits and cutting back Medicare. For this reason, these days Republicans pushing back against President Obama's health care plans seem to be getting most of their ammunition from the Heritage Foundation.
The Role of Conservative Think Tanks
It's important to understand that the role of the Heritage Foundation and the other "think tanks" is not to find solutions to America's problems, but to craft arguments in favor of a right-wing ideological perspective on those problems. If you watch them closely, you realize their "solutions" are worked out backward, beginning with the "conclusion" -- global warming is not man made, government regulation is bad, taxes must be cut -- and then "data" is generated to support the solution. Their real product is not the solution, but the argument in favor of the solution.
The die-hard right-wing base is fueled by fear, bigotry and resentment, not policy. But to stop health care reform Republicans have to maintain some semblance of credibility to a broader spectrum of Americans, people who are not necessarily crazy. And to do that, Republicans need credible arguments, or at least arguments that seem credible if they aren't examined too closely.
Right now, the Heritage Foundation appears to be the primary generator of those arguments. Although its own health care proposals are pitifully thin, they are less alarming than the most substantive, if lunatic, ideas being expressed by Cato and other think tanks.
I keep close watch on what's coming out of the conservative think tanks, because they and the "astroturf" organizations they work with are the most effective opposition to health care and other progressive issues, such as union organizing, which is related to workplace safety; environmental protection; and citizens' tort rights; which are critical for people suffering asbestos-related disease such as mesothelioma, for whom I work as an advocate. But they are critical to all of us as well.
The Heritage Foundation
The Heritage Foundation was established in 1973 to promote "free enterprise, limited government, individual freedom, traditional American values, and a strong national defense," according to its website. According to SourceWatch, "Its initial funding was provided by Joseph Coors, of the Coors beer empire, and Richard Mellon Scaife, heir of the Mellon industrial and banking fortune."
The Heritage Foundation is possibly the most well-known and influential of all the right-wing think tanks. It moved to the head of the line during the Reagan Administration, which leaned on Heritage heavily for ideas and talking points. According to SourceWatch, corporate sponsors of Heritage include a number of insurance, medical and pharmaceutical companies. Pfizer and the lobbying group Pharmaceutical Research and Manufacturers of America were among its $100,000-plus donors in 2006.
Heritage has been called a right-wing agitprop machine. More than ten years ago Jacob Weisberg wrote that Heritage "is essentially a propaganda mill.".
But on the whole, Heritage is focused on selling and promoting its views rather than on developing thoughtful or nuanced ones. It spends nearly half its $29 million annual budget [$40.5 million in 2006] on marketing. It prides itself on producing reports with concision and speed. According to Edwards, one recent innovation is the colored index card summarizing a conservative position in "short, punchy sentences." According to Heritage's "Vice-president for information marketing," these cards have been "wildly successful" with Republicans in Congress.
Heritage's chief products are its article-length "backgrounders" on current issues that are faxed and emailed to politicians, journalists and public officials. Since the 1980s the Heritage backgrounders have played a large role in shaping the Right's arguments and talking points. And they're still at it. Recently Heritage commissioned The Lewin Group, "a highly respected health care policy and management consulting firm," to issue a report claiming President Obama's health care policy proposals could cause millions of Americans to lose their private, employer-based coverage. Predictably, Republicans on Capitol Hill picked up this talking point and repeated it ceaselessly. Louisiana Governor Bobby Jindal wrote an op ed for the Wall Street Journal citing the Lewin Group study. No one happened to mention that the Lewin Group is a subsidiary of UnitedHealthcare, a major health insurance company.
Further, the Lewin Group numbers seemed to be mostly fantasy. Congressional Budget Office data refutes the Lewin Group study point by point. But this has been the Heritage Foundation modus operandi for years -- cranking out vast numbers of dubious "studies" in support of the right-wing political agenda.