I was in high school in California when Congress wrestled with the Medicare bill in the 1960s. The temper of our town was extremely conservative, and I remember then the same combination of heartfelt, and eventually panicked and despairing, warnings by opponents of the bill that I have heard from opponents of the current health-care plan these past few months. Big spending, big deficits, big government, end of choice, destruction of the doctor-patient relationship, intrusion of the bureaucrat, erosion of the American way. The mood was just as committed, angry, impassioned, and beyond the reach of mere "let's talk about the facts" discussion as it is now. That background doesn't prove that fears about the current bill are ill-founded. But it needs to be remembered.
At the time I didn't register the significance of Medicare's passage -- something now so engrained as part of the American Way that today's Republicans have positioned themselves as its protectors (against the alleged ravages of the Obama plan). I think that these two quick-reaction TNR articles -- by Jonathan Chait, here, and Jonathan Cohn, here -- do a wonderful job of registering the significance of the Senate's 60-39 vote today in favor of the bill. Chait's is particularly thorough in parsing and addressing the main objections to the bill. These two writers, plus Ezra Klein of the Washington Post, have through the long course of this debate provided a clinic in how to explain the policies and the politics of a very important, very controversial, and very very verrrrrryy complicated public decision.
The Republican opponents of Medicare in my youth at least had something they were for. They had Barry Goldwater's Conscience of a Conservative; they had Ronald Reagan with his recorded addresses on how socialized medicine was the route toward socialism of all sorts. Even though in practice Reagan's pitch boiled down to flat-out opposition to Medicare, the idea-content of his opposition now seems about 100 times greater than what we've become accustomed to hearing from Fox News or at tea-party rallies.
The Republican coalition of that time had its "reactionary" elements, notably those white Southerners who were being peeled from the traditional Democratic coalition by their reaction to the civil rights era. The John Birch Society was of course already part of the team. But the conservatism of Goldwater and Reagan didn't seem to be the pure reaction, pure oppositionism, pure emotional outrage that to me comes through many anti-Obama speeches. Newt Gingrich was not Ronald Reagan's equivalent as a political leader nor Goldwater's as progenitor of a movement. But when he led the GOP's efforts to stop Clinton's health care plan and its subsequent takeover of the House in 1994, he very prominently offered "ideas" and a "plan." (Viz, 'Contract with America.')
When the most visible faces and most prominent voices of Republican sentiment are Palin, Limbaugh, Beck, McConnell, and Boehner, aggrieved oppositionism is possible, but a Reagan- or even Gingrich-scale movement is hard. They await their leader. In the meantime, it is a moment to note.