Anthony Tsontakis has offered an interesting and thoughtful comment on my September 20th blog post: "Why Does the Right Hate Obamacare?" [Every so often Brian Leiter links to this site and for a day or two my site visits are off the charts. I assume that Mr. [Dr.?] Tsontakis was directed to that relatively old post by Leiter's recent link.] Here is the entire comment:
"Robert, I would be curious to hear what you might think of a counter-hypothesis formulated along these lines--one that does not make reference to racism to explain the hysteria. Here is an outline of the counter-hypothesis (very roughly formulated): The hysteria can be explained by a fundamental philosophical disagreement between, say, Republicans and Democrats, or the political right and the political left. On this theory, three things would be relevant about the ACA: 1) It effectuates a large-scale redistribution of wealth; 2) It effectuates a large-scale intervention by the government into the economy; and 3) It rearranges social relations on a fairly massive scale. I think what I mean by (1) and (2) is fairly straightforward. What I mean by (3) is that the ACA rearranges relations between individuals and state governments, individuals and the federal government, individuals and employers, individuals and health insurance companies, employers and state and federal governments, and between the state and federal governments themselves (and perhaps more). I think (1), (2), and (3) are fair descriptions of at least some of the major things that the ACA does, speaking, of course, in very broad and general terms. If that is right, then I would think it natural for people ideologically disposed to the right-wing of the political spectrum to be vehemently opposed to the ACA, because the ACA violates philosophical principles that are profoundly important, if not outright fundamental, to the political right."
Before I offer a response, let me make one thing quite clear. My knowledge of the beliefs and sentiments of those on the right is based entirely on things I have read or have seen on television. I have never had a conversation with a committed right-wing opponent of the Affordable Care Act, nor have I even, to the best of my knowledge, met one. You would be quite correct in inferring that I live in a left-wing bubble [called Chapel Hill -- before that, I lived in a left-wing bubble called Amherst, MA, and before that I lived in the right wing bubbles called Morningside Heights, Hyde Park, and Cambridge.] If this strikes you as disqualifying my from having an opinion, you are free to ignore the rest of this post.
Anthony Tsontakis states as fact three things about the Affordable Care Act. I have my doubts about the truth of his claims, but for purposes of this response I shall assume that he is correct about all three. I do this because my post sought to explain not the principled opposition of conservatives to the ACA, if in fact there really exists such principled opposition, but rather the intense -- in my view hysterical -- hatred that those on the right voice for the ACA and for the person principally associated with it, Barack Obama. It is that intense animosity that I sought to anatomize.
First things first. The central features of the ACA entered public discourse in America as a set of conservative Republican proposals put forward by the right-wing Heritage Foundation as alternatives to the single-payer model of health care reform advanced by the centrist Democrats of the Clinton Administration. The principal aim of the Heritage Foundation thinkers was to preserve the private insurance core of the American health care model, despite the fact that this reliance on private insurance has driven American health care costs far above those in other mature industrial capitalist national economies. These much higher costs impose a significant drag on the competitiveness of the transnational sector of American capitalism, a consideration that weighs heavily with conservative defenders of American capitalism. The most controversial element of the Heritage Foundation proposals -- what is now called the Individual Mandate -- was dictated by a well-known and universally acknowledged fact about all insurance schemes, which is that they can be made affordable only if the population covered includes those less likely, as well as those more likely, to file claims.
The model proposed by conservatives received one trial prior to the passage of the ACA -- a health care system reform enacted into law in Massachusetts by a [then] moderate Republican governor, Mitt Romney. During the 2008 presidential campaign, liberal and left-wing Democrats argued vehemently for a single-payer reform, rejecting as insufficiently redistributive and inadequately progressive the Heritage Foundation/Mitt Romney model. After his election, President Obama made a major and ultimately successful political effort to enact a comprehensive reform of America's health care system. Despite controlling both houses of Congress, Democrats were quite incapable of overcoming Republican opposition to a single-payer reform, and were forced to settle [by the skin of their teeth!] for the conservative Heritage Foundation plan pioneered by Romney in Massachusetts. One of the compromises forced on the Democrats as a means of holding the support of "blue dog" Democrats and winning the crucial support of a tiny handful of moderate Republicans was a postponement of implementation of several of the most controversial features of the ACA until after the 2012 elections.
In light of this well-known and quite uncontroversial history, I find it unlikely, to say the least, that the explanation of the present right-wing opposition to the ACA is that, in Anthony Tsontakis' words, it "violates philosophical principles that are profoundly important, if not outright fundamental, to the political right." The core ideas of the ACA did not violate those principles in the late '90s, when those ideas were advanced by the political right, and I am quite unaware of any deep, far-reaching change in the philosophical principles of the political right in the intervening time.
A secondary support of my thesis is the evidence that even the most intense opponents of the ACA are found, repeatedly, to support particular elements of that program when those elements are presented to them without any association to the ACA. I have in mind the covering of children on their parents' health insurance until the age of 26, the elimination of pre-existing medical conditions as a reason for refusing private health insurance, the lifting of lifetime caps on benefits, and so forth.
There is even some fragmentary polling data that suggest that the real object of the antipathy of many opponents of the ACA is simply the name "Obama." When asked which they prefer, the Affordable Care Act or Obamacare, a number of people say that they like the ACA and hate Obamacare.
Finally, I will mention again the striking fact that occasioned my original post, namely the element of hysterical hyperbole characterizing the utterances of the opponents of the ACA. Now, as I indicated when I began this response, my knowledge of that hyperbole is entirely secondary. It is certainly possible that the media, with their well-known penchant for what we might call shock-journalism, have deliberately featured the wildest and most irrational opposition to the ACA, thereby concealing from view the measured, reasoned, principled views characteristic of the great majority of opponents. Maybe so. But I doubt it.
So, for all these reasons, I doubt that Anthony Tsontakis is correct. If he is wrong and I am right, then we are confronted with the question to which my original post was addressed: Whence the extraordinary, hysterical animus? My explanation may of course be wrong, but I think my question is pertinent, and calls for factors that are much psychological and ideological as they are factual or philosophical.