7 ways radical moderates could change the health-care debate

The common misconception about moderates is that they are mushy compromisers, willing to split the difference in search of deals. They are accused of having no ideological grounding or set of principles.

In fact, moderates tend to have strong principles, and we’re seeing a good illustration of that in the Republicans who are resisting the Senate health plan.

But first, a definition.

Peter Wehner, a conservative thinker and former official in President George W. Bush’s administration, put it this way:

“Moderation does not mean truth is always found equidistant between two extreme positions, nor does it mean that bold and at times even radical steps are not necessary to advance moral ends. Moderation takes into account what is needed at any given moment; it allows circumstances to determine action in the way that weather patterns dictate which route a ship will follow.

“But there are general characteristics we associate with moderation, including prudence, the humility to recognize limits (including our own), the willingness to balance competing principles and an aversion to fanaticism. Moderation accepts the complexity of life in this world and distrusts utopian visions and simple solutions. The way to think about moderation is as a disposition, not as an ideology. Its antithesis is not conviction but intemperance.”

The real moderates, and the best display of moderate politics we have seen this year, are on display in the health-care debate.

Here are seven ways Republican moderates in the Senate are demonstrating the true attributes of moderation in their struggle to find an acceptable and worthwhile outcome from the current chaos and paralysis that envelops the GOP.

To begin with, moderates need not be followers, or weak sisters and brothers. Here Republican Sens. Susan Collins, Bill Cassidy, Shelley Moore Capitoand Rob Portman (usually not considered a “moderate”) are leading the charge. They stood up to White House and leadership pressure. They took a stance for which they knew they would be attacked. In doing so, they derailed a rushed vote on a terrible bill. They have stopped a bill — for now — that would leave millions of vulnerable Americans without health-care coverage.

Second, they are not split-the-baby types. They have not said, “Could we throw just 15 million off Medicaid?” They have not said, “Maybe if we just whack older, sicker and more rural Americans a little less, we could get on board.” This no doubt perplexes leadership, who will try to buy them off with a one-time lump payment for opioid abuse. So far the moderates aren’t buying it.

Third, moderates have a nose for where interests overlap and deals can be made. They rightly see that there will be no bill if mammoth tax cuts for the rich are paired with big Medicaid cuts, so take both off the table. They identify the problem — the exchanges — that is capable of a solution. The Collins-Cassidy health-care bill introduced in January suggests some states could keep the Affordable Care Act while others could adopt a system that provides comparable benefits. But they are flexible as to the means for achieving their aims.

Fourth, they state their priorities: Providing affordable coverage takes precedence over tax cuts for the rich. (To their credit, hard-right opponents of the Senate bill such as Republican Sen. Ted Cruz of Texas are hinting they will do the same.)

Fifth, they have a simple rubric: What’s best for the people I represent? They reject turning concrete, specific policy choices into sweeping statements of ideological purity. The goal of the health-care bill should be improved health care, not “freedom” (to be dumped from Medicaid?). They take a problem-solving approach that allows negotiators to overcome tribalistic instincts. “Republicans don’t believe in X” can become “Republicans can accept this solution because it does Y.”

Sixth, they do not hide behind rash promises (Repeal and replace Obamacare with something cheaper that covers everyone with better coverage!). They are willing to adopt the Burkean view that representatives owe the public their best judgment and expertise, not a mouthpiece who channels the voice of the mob.

Seventh, they refuse to make up facts to suit their argument. Collins point-blank rejects the notion (already rebutted by the Congressional Budget Office) that Medicaid isn’t being cut in the Senate bill. (Simply put, if you got the promise of a 1 percent raise every year with the cost of living going up 2 percent, would you be satisfied that your salary isn’t being cut? And, if you knew your boss would only fund half the raises he promised, would you feel secure?)

There is no guarantee this will work; in fact, given the GOP leadership and the White House, it likely won’t. But it is the sort of politics we should aim for.

Democrats and Republicans will fight over how big the state, how high the taxes, how uniform the rules must be. They can fight over priorities (tax cuts for the rich vs. fiscal sobriety).

But the aim can be to solve the problems they can and avoid blowing up the system for the sake of tribal identity. That’s all we can expect from politicians.

This story was originally published June 30, 2017 at 11:41 AM with the headline "7 ways radical moderates could change the health-care debate."