Among other things, the fight over health care reform is also a fight over two very different views of for partisan alignment works.

There’s a strain of thought that some conservatives push that the main reason Democrats support health care reform — and the reason Democrats support other government programs, everything from Social Security to Medicare — is to essentially trick otherwise fine, upstanding, independent Americans into becoming thoroughly dependent on the government, and therefore having no choice but to vote for Democrats.

On the other hand, there’s, well, reality. In fact, it turns out that voting doesn’t work that way at all; after all, it’s hardly the case that older Americans massively favor the Democrats.

And to the extent that issues matter, the truth is, if anything, the opposite. Health care reform, for example, has generally been an excellent issue for Democrats for decades precisely because it’s a generally recognized problem, and Democrats seem much more interested in doing something about it. Indeed, if the Affordable Care Act survives court challenges and eventually gets fully and successfully implemented, most people will treat it as a normal part of the way things are and always have been, and (again, to the extent that issues affect their voting choices) they’ll move on to other things.

I bring this up now because I think it’s the context for the Heidi Heitkamp ad that Greg Sargeant wrote about earlier today. Heitkamp is running as a Democrat for the open North Dakota Senate seat; the seat was widely assumed to be an easy Republican pickup, but in fact the polling so far has her basically even with Republican Rick Berg. And she has a new ad out touting the “good things” in the ACA – such as the provisions for pre-existing conditions. The point here is that the normal order of things is very much for Democrats to be running ads touting their (popular) position on health care, while Republicans find something else to talk about. The only time that was different was precisely when Democrats actually did what they’ve always said they wanted to do about health care.

I agree with Greg; I don’t think that in the short run a Supreme Court decision to knock out ACA would help Democrats. Indeed, I don’t think it will have any significant effect on the 2012 election at all. But in the long run, I think it’s most plausible to suppose that Democrats do better when health care problems are in the news, and so if knocking out the ACA makes that more likely, then it’s probably good news, long-term, for the Democrats. (See more generally the idea of “issue ownership.”) Now, it’s a bit more complicated than that: No one really thinks that even spectacularly successful implementation of reform would “solve” health care, for example. But generally it’s a lot more plausible than conservatives’ “hopeless dependents” version of how things work, which as far as I can see has no evidence to support it at all.