Free to Die

In the past, conservatives accepted the need for a government-provided safety net on humanitarian grounds. Don't take it from me, take it from Friedrich Hayek, the conservative intellectual hero, who specifically declared in "The Road to Serfdom" his support for "a comprehensive system of social insurance" to protect citizens against "the common hazards of life," and singled out health in particular.

Given the agreed-upon desirability of protecting citizens against the worst, the question then became one of costs and benefits - and health care was one of those areas where even conservatives used to be willing to accept government intervention in the name of compassion, given the clear evidence that covering the uninsured would not, in fact, cost very much money. As many observers have pointed out, the Obama health care plan was largely based on past Republican plans, and is virtually identical to Mitt Romney's health reform in Massachusetts.

Now, however, compassion is out of fashion - indeed, lack of compassion has become a matter of principle, at least among the G.O.P.'s base.