Dr. Maccoby participates in a Weekly Forum on Washington Post.com called "On Leadership". I am compiling all of his responses to the weekly questions here.

Principled conservatism

This week's health care summit presents Republican leaders with a difficult choice: (1) agree to support a plan that might be modestly changed to accommodate their ideas; or (2) oppose it on principle as too costly and intrusive and use the issue to try to gain political advantage in November. Which strategy offers them the best prospect of regaining power?

The political "experts" think Republicans will regain power in Congress by sinking all Democratic initiatives, especially health-care legislation. Without doubt, this strategy appeals to the Republican base which never supported the idea of universal health care. But Barack Obama, who campaigned on this promise, was not elected by the Republican base, but by Democrats and independents.

The Republican attack on the health-care legislation has confused the public with threats of "death panels," cuts to Medicare, ballooning deficits and oppressive government control. Right now, the polls show that this strategy has turned the majority of the voters against health-care reform. But when the time comes to elect a new Congress and more people find themselves without insurance or with growing bills, the public may blame these Republicans for sabotaging progress.

To avoid primary challenges from the far-right voters who are most likely to vote, some Republicans need to stick to a strategy of "no" against any Democratic initiative. But others might be wise to take a principled conservative position on health care policy, emphasizing cost control and incentives for quality.

Imagine the positive response of independents at the polls to those Republicans who would say, "We recognize that the costs of Medicare cannot be sustained and the insurance system needs reform. We will support a bill that honestly deals with these issues and calls for equitable sacrifices as long as it does not increase the deficit."

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