Salon's Ed Kilgore says conservatives are using the same tactics they used against welfare in the 1990s against health care reform today, by suggesting that health care reform would take coverage away from those who deserve it and give it to people who are too lazy to earn it. This is an ideological, emotional way of looking at what Republicans are doing; Kilgore suggests it's founded on sentiment that President Obama is a socialist, and the right's anti-ACORN rage and accusations of class warfare on behalf of candidate Obama.
Conservatives have fervently accused Obama of class warfare, but now they're not doing that quite as much: the talking points against health care reform, rather, are that it would 1) cut Medicare benefits--something both Democrats and the AARP say is not actually true, in any of the proposals that currently exist--and 2) that it would spend too much and drive the government deeper into irresponsible debt.
When one calls Obama's health reform "socialism," what does that mean? Do people react more to a nebulous, European style of government they don't like, or is it more about government spending and debt? Or is it about an alleged class war, waged by a liberal president with community-organizing roots of which the most adamantly anti-Obama conservatives are suspicious?
It probably means different things to different Republicans. The Randian, producers-vs.-lazy-bums narrative isn't the main one conservatives are using against health care, at least out loud. Kilgore sees it astutely, but it exists more as a dog-whistle, to the extent the word "socialism" conjures it among various political audiences--one that resonates soundly with the hardest of anti-Obama conservatives for whom the class-warfare narrative was already established in 2008, and probably less so with others.