HealthcareHorserace.com recently introduced you to Grover Norquist, “the most influential conservative you’ve never heard of“. As a veteran of the first healthcare wars and a Beltway fixture for nearly three decades, Norquist has been at the forefront of the conservative movement and - along with a couple of guys named Gingrich and Rove - has played a major role in rebuilding the conservative brand. He was a co-author of the 1994 Contract with America which ushered in the new age of conservatism in America and ultimately led to the presidency of George W. Bush. Perhaps no issue better illustrates the evolution of the conservative voice better than healthcare reform.

The “Party of No” becomes the Party of Ideas … Again

Norquist will be the first to admit that “no” was a winning strategy when Hillary Clinton attempted to push healthcare reform through 16 years ago.

[Democrats] almost passed “healthcare reform” back in ’93 and ’94. They failed because they made no effort to reach out to Republicans and because the White House didn’t work as well with Congress as they might and because the business community was pretty united in saying “no”. You had individual companies that wanted the government to absorb their “legacy costs” – General Motors, American Airlines, all the unionized companies thought it was a great idea because they thought a government takeover of healthcare would allow them to hand-over or to void their union contracts and have the government run their healthcare for them like Medicare and Medicaid. Eventually, they figured out that [Democrats] were going to exempt gold-plated union contracts, so that didn’t work for the business community.

Things aren’t quite as simple this time around. A failing economy has left business leaders in a defensive posture and union leaders in a position of strength. A series of poorly executed corporate bailouts and a complete lack of fiscal restraint in the White House has set a “money is no object” precedent and left the American people wondering when help will arrive for them. And, perhaps one of the most politically motivated and partisan Congressional leaderships in the history of our country has labeled political dissent as obstructionist and un-American.

One of the things that Obama and some of the Democrats have done is say we have a plan and you have no plan. Well, that was always a lie. They just spent eight years stopping Republican healthcare reforms everyday. That’s what they did for a living. Now, of course, you put many of those reforms together in the DeMint bill and it allows any Republican elected official to say here’s my plan, here are the eight different ideas in it and I’m for this and I’m against their craziness. It’s a big help to have something you’re for – not that the Democrats would vote for it.

Putting Ideas on Paper: The DeMint Healthcare Freedom Plan

Part of beating [a Democrat] bill is to have a clear statement of what reform you want because people have a sense that there are problems – the price keeps going up and the trial lawyers are stealing all the money. We need to point out our bill deals with the bad trial lawyers, their bill doesn’t. Our bill reduces costs, their bill raises costs. Our bill cuts taxes, their bill raises taxes.

Senator Jim DeMint’s Healthcare Freedom Plan lays out a clearly conservative strategy that promises to ”insure more Americans in half the time at no cost.” According to literature posted on the Senator’s website, the right approach to reform is one that:

• Protects the right of Americans to keep their employer-based plan without having to pay additional taxes on those benefits.
• Provides Americans without employer-based coverage with vouchers of $2000 for individuals and $5000 for families to purchase health insurance. The premium for the average private policy sold in the individual market in 2007 was $1,896 for an individual and $4,392 for a family (Source: eHealthInsurance)
• Allows Americans with Health Savings Accounts (HSAs) to use their HSA funds to pay for insurance premiums, encouraging employers to contribute to their employees’ HSAs.
• Creates a nationwide market for health insurance by allowing individuals to purchase health insurance plans in any state.
• Provides block grants to states to develop innovative models that ensure affordable health insurance coverage for Americans with pre-existing health conditions.
• Reduces predatory and frivolous malpractice lawsuits against physicians and hospitals.
• Assures that every health care consumer has access to price information prior to treatment so they can make informed decisions about their care.
• Repeals financial bailouts (TARP) to ensure that the plan does not add to the deficit.

(Taken from a press release announcing DeMint’s Healthcare Freedom Plan.)

If the ‘93-’94 healthcare battle was the first of a protracted war, Norquist - like any good general - has learned from both the victories and defeats of the past.

So, one, you can say [the Democrat proposals are] worse than the present status quo – it will make things worse, not better. And, two, we have something to make things better. Step one is stop the bad stuff. Step two is be there with your reforms when you’ve got the votes to enact them.

If you snapped your fingers and put the Republicans in charge of the House and Senate, we didn’t go into the Republican control of the House and Senate in ’93 and ’94 with an articulated list of reforms that we were for. For instance, The Contract with America I don’t think focused on specific healthcare stuff, like healthcare savings accounts. That’s why fighting the Democrats allows Republicans and conservatives to focus on a series of reforms that we can explain and vote for and explain publicly.

The Debate within the Republican Party: Selective Amputation?!?

Of course, the DeMint Healthcare Freedom Plan isn’t the only Republican healthcare reform proposal on the table. Dr. Tom Coburn was joined by Republican Congressmen and Senators in authoring The Patient’s Choice Act of 2009. Many conservatives - including Norquist - view the Coburn bill as an amalgamation of liberal and conservative ideas on healthcare reform that concedes and aims to water down an eventual Democrat victory.

There are always people who when the other team wants to cut off two of your fingers, want to negotiate to lose one finger. And, so they run around with a lets only cut off one finger argument. That’s an insider’s game; it’s the kind of thing you can sell a Congressman or a Senator. It’s not the kind of thing you can go give a speech to the Chamber of Commerce or a state taxpayer group and say here’s what we’re going to do: we’ll be for small tax increases on all of you - yeah! What?

Politicians are particularly prone to how about if we just cut off one finger and you should appreciate all my work to protect your second finger. If you’re going to run a campaign where you have to get popular support, we need to be the no fingers cut off leaders.

Getting one finger cut off is the prelude to them coming back for the other finger. That’s why the DeMint proposal – which is not a compromise but is a bold, conservative, free-market approach, is so helpful. The guys who say lets cut off one finger instead of two or three, think that’s the only alternative way to do it.

To Norquist’s mind, that difference in philosophy is nothing less than a battle for the hearts and minds of the conservative movement. The “let’s only cut off one finger” camp appears to be led by The Heritage Foundation, which came out in support of the Coburn bill. Norquist’s own Health Care Freedom Coalition, which publicly supports DeMint and his Healthcare Freedom Plan, is out there trying to save your hand.

First of all, in a free society you can never speak with one voice and you wouldn’t want to be able to force it. There have been some efforts by some on the right – and Heritage did this in ’93 and ’94 [and again with the Coburn bill] – where they had an alternative that, in my view, was too much government. And, in their view, they thought if we don’t do this, [the Democrats] pass something worse.

Drawing a Line in the Sand: What it means to be a Republican

Norquist clearly believes that the battle over healthcare reform will determine the future of a Republican party grappling with what it means to be a 21st century American conservative. And, in doing so, he turns to the 20th century political icon who reinvented the Republican Party.

Ronald Reagan came in and said, instead of debating how much we’re going to raise taxes, here’s what we’re going to do: we’re going to cut them. Whoa! That’s a much stronger position. Instead of negotiating to lose slowly we’re going to beat them. Those are game changers.

I think you’re much better off with a common sense radical proposal than with anything that’s a compromise. Compromise is convoluted and difficult to understand because its being drafted between what we have and what somebody else wants, so its more complicated than the status quo, more complicated than the other guys idea and complication is the enemy of people with short attention spans and that’s most people these days. Because, they’re busy. They have lives.

The House doesn’t read the bills, why do you think the American people are going to read and understand these bills? So, I am a strong advocate for going on offense rather than defense. And, being the don’t cut off any fingers – not take one or two and leave the rest for us this week.

This will be a battle to the bloody end and one in which surrender is the ultimate defeat. Defecting to the side of compromise is treason and is punishable by expulsion from the conservative movement. Norquist’s Healthcare Freedom Coalition has already begun to name potential Republican turncoats who - in their words - “are going to make you buy health insurance“, “support price controls“, and “support a guaranteed coverage (guaranteed issue) mandate“.

If the administration passes something and they have a liberal Republican joining them, nobody thinks they’ve done something that wasn’t liberal. The two women from Maine (Senator’s Olympia Snowe and Susan Collins) voted for the stimulus package and everyone hates the stimulus package and everybody thinks it was a crooked, bad thing Obama and the Democrats did. Nobody says oh it’s bipartisan because the two liberals from Maine voted for it. That’s not bipartisan.

And the same thing, anybody who votes for government run healthcare is going to be somebody who kind of by definition isn’t an R[epublican]. It would take 20 Republican votes to make it bipartisan in the Senate. That isn’t happening. So, it won’t be bipartisan even if they pick off some guy and pretend it is.