In dozens of conversations with left-of-center journalists, activists, and politicians, I’ve detected a deep sense that turnabout is fair play. The questions raised by conservatives regarding the costs of the president’s approach to health reform are essentially illegitimate because the previous administration was responsible for tax cuts that were not matched by spending cuts, an unfunded new entitlement program, and two expensive military campaigns. This strikes me as an interesting, coherent, and hilariously irresponsible view.

Arguendo, let’s accept that the left critique of the Bush administration is right in all the particulars. Let’s also assume that the Peterson Foundation and other nonpartisan groups that have noted the gap between likely costs and likely revenues of the president’s reform proposals are not members of a “right-wing noise machine” that actually delights in the prospect of denying Americans access to crucial medical care. Where does that leave us? The centrist opposition to the particular design of the president’s health reform has been largely ignored, for the understandable reason that the centrist opposition doesn’t threaten to dislodge Democratic lawmakers. The Republican opposition is in a sense the only effective opposition, as the Republican party can do what the centrist intelligentsia can’t. It should go without saying that Republicans don’t generally embrace the ideological worldview of the centrist, budget-balancing critics I have in mind, who want spending cuts and tax increases to deal with out long-term fiscal crisis. But there is a real sense in which the budget-balancing center and the right are objective allies insofar as they encourage an emphasis on delivery-system reform and whether or not the cost of premium subsidies will prove sustainable.

Virtually no one believes that we can afford universal coverage without new taxes that will impact the “bottom 95 percent” of the population, yet my left-of-center interlocutors believe that the supposed anti-tax “insanity” of the GOP means that Democrats are obligated to be sparing with the truth.

My own view is different: I think that the party that respects the American public will be rewarded for doing so. If the president openly and honestly explained to the American public that he believes that American workers should trade some disposable income for less risk, and that this tradeoff should happen through taxes and transfers, my guess is that a majority of Americans would, despite conservative objections, embrace the idea. Instead, the White House has emphasized that finding efficiencies through an iterative, centralized series of Medicare reforms as a way to finance coverage. To be sure, this is a matter of emphasis. (Anti-war critics often accused President Bush of selling the Iraq invasion in a misleading manner; this was mostly a matter of emphasis, that is very difficult to prove or disprove to partisans.) This kind of Medicare reform sounds very attractive to me, just as it sounded attractive to Newt Gingrich and the Republican Congress. But should we be surprised that seniors are concerned? Moreover, is it fair to malign for seniors for being concerned?

Left-of-center observers often cite signs — many of them apocryphal, but some of them real — demanding that government keep its hands off of Medicare, a laugh-line for those who essentially believe that most Americans are easily-duped rubes. (I’m not exaggerating.) The conceit is that there are no sincere critics of small government, and that selfishness underlies all opposition to the agenda of the Democratic party circa 2009. Indeed, some observers have concluded that reversals for said agenda constitute a threat to democracy. Note that many of the same observers believed that political success for conservative Republicans in 2002 and 2004 was also a threat to democracy. Political success for liberal Democrats, in contrast, never represents a threat to democracy.

You might recall that many right-of-center intellectuals found themselves in a similar spot during the early Bush years: convinced that a Republican White House must be defended, many conservatives compromised their core principles, and insisted that the hypocrisy of the Democratic opposition was reason enough to justify any number of misguided policies. I think it’s fair to say that this approach didn’t end well.

It could be that we’re in a poisonous political moment and we have no choice but to throw up our hands. Conveniently, many on the left believe that the only way to break this logjam is to permanently crush the Republican party so that objections to taxes and overspending will be permanently silenced. One popular new notion is that the Democratic party itself represents the full spectrum of responsible opinion, from Blue Dogs who want to spend a corporation-friendly $900 billion to Progressives who want to spend a somewhat-less corporation-friendly $1.4 trillion.

At the risk of coming across as a threat to democracy, this doesn’t sound right to me. I’d rather the Republican opposition take a different approach to countering the president’s health reform effort, one that emphasizes cost-effective alternatives to achieving universal coverage.