I'm amused, watching the give and take of Democrats in a state of denial over their ill-conceived health care reform package. Liberal Democrats, led by Speaker Pelosi, angry at hints that centrists may drop the sacrosanct "public option" (i.e., government-run health care), have vowed to vote against any compromise bill. There is even renewed talk of using the so-called "nuclear option", using unconventionally a budget reconciliation process to bypass Senate filibuster rules. I'm confident that is pure bluff.
The "Nuclear Option" is Unlikely
First, it would be political suicide to push a bill that polls already show is against public sentiment; it would occur with no Republican support. The Democrats should be very cautious because they should remember the last time they tried to ram national health care down the nation's throat--they ended up getting voted out of power in the Congress in 1994. The Clintons turned a compromise proposal from Senator Dole for catastrophic health insurance. But if Obama and the Congressional Democrats think that the answer to their own declining approval ratings is to double-down and push through a costly government-run option allegedly to help the uninsured with an existing $1.25T deficit and nearly 10% unemployment, they are delusional. The fact is that innovative state plans (e.g., Massachusetts) are drowning in red ink--even when allowing hardship exemptions from a coverage mandate. Adding new patients to an already costly system not only could have unintended consequences for existing policyholders in the private sector (e.g., if businesses drop their plans in a cost-saving move), but federal cost coverage could affect access and quality of health care for seniors (i.e., Medicare cuts), add disproportionately higher costs for smaller businesses (affecting business growth and employment), and will likely adversely affect patient time with family physicians, given limited slack capacity of available and supply of new doctors.
The facts that Obama and the Democrats have to date refused to seriously consider medical malpractice tort reform (because of their ties to trial lawyers) and that they are looking to cut Medicare or Medicaid reimbursements, even as these patients are already essentially subsidized by business from private sector patients, underscores the Democrats' failure to adequately address the provider supply side of the equation. Any loss of private sector market share necessarily implies that the federal government will have to pay its fair share or further drive down the supply of physicians at the very time they are seeking to expand the number of aggregate patients. Any government-run program will never be allowed to pass along its true costs to public program policyholders, because payments are subject to political pressure, not economic factors; the private sector cannot afford to do this from a long-term perspective. This is an inherent form of corruption and makes for fundamentally unjust competition, the same kind of muddled thinking that led Freddie Mac and Fannie Mae to dominating the home mortgage market from a single-digit percentage share in the early 60's--and we know what resulted from this Democratic-sponsored expansion using their GSE access to cheap Treasury funds as a competitive advantage, i.e., a key element of last year's economic tsunami.
Taxpayers, I believe, understand this bureaucratic power grab for exactly what it is. We, as human beings, have all sorts of needs and desires, e.g., food, shelter, utilities, clothing, as well as medical assistance. Our Founding Fathers understood that; they did not guarantee coverage of these needs; in fact, economic liberty ensures a vibrant private sector that addresses these needs. The federal government seems to understand, at least in other sectors, that the solution to ensuring fair, affordable access is to provide reasonable guidance, regulations, and subsidies, not some fiction of providing "competition" to keep the private sector honest: If sugar prices are high, farmers, on their own, will chase the higher prices; there's no need for the government to get in the sugar plantation business in order to guarantee low sugar prices. What "progressives" fail to point out is that health care is business, just like any other business, subject to the same concepts of supply and demand. What we do know is that farmers, as businessmen, will cut back on their costs, including their use of temporary help during planting and harvesting, in an adverse market; the federal government has hardly given us assurances it would lay off federal workers on the plantations, not to mention the heavy bureaucracy running them--and no doubt have no problem with dumping below-cost sugar on the market, justifying it as a "pro-consumer" move, but in reality anti-competitive behavior, undermining the natural incentive for private-sector farmers to plant sugar. Generally speaking, we have seen the federal government resort to temporary assistance, e.g., welfare and subsidies, to help manage living costs.
Second, if the Democrats were to use gimmicky tactics in an unprecedented move to pass major policy, it would essentially undermine the integrity of the Senate itself and the very compromise underlying our Constitution: it would undermine states' and pluralist rights. It would render the filibuster essentially moot. It would all but ensure full-fledged bipartisan war in Congress, undermining any chance Obama has to carry the rest of his agenda. From a political standard, even senior citizens, who have often supported Democrats for political support of generous social security and Medicare assistance, understand the implications of health care rationing, e.g., the horror stories of Canada's single-payer system where patients sometimes experience a devastating delay in treatment of diseases like cancer or effective new prescription drugs are not used because of their cost. The Democrats seem to forget they were out of power in Congress just 3 years ago, and elections can reverse political fortunes quickly (e.g., among Democrat US Senate seats in danger in 2010: Barbara Boxer (D-CA), Harry Reid (D-NV), Chris Dodd (D-CN), Biden's old Senate seat (D-DE), Gillibrand (D-NY), and Burris (D-IL)). The point here is that I suspect some Democrats will essentially join with Republicans in a revamped version of McCain's Gang of 14, which preserved the potential use of filibusters, if not in terms of principle, then surely out of the fact that Republicans, if and when the tables are turned, can use the same tactics.
Democrats Underestimating the Electoral Consequences of "Progressive" Arrogance and Condescension
Rep. Eric Massa (D-NY), who won by 2 percentage points in a Republican-leaning district during a change election, has recently been quoted saying to progressive activists that he would vote against his own district's interests, not only in supporting the idea of government-run health care in HR 3200, but in pushing for a single-payer system. This kind of arrogance is part of the reason that Republicans next year are targeting at least 70 US House seats held by Democrats (especially Massa), including over a dozen Blue Dogs next election. Speaker Pelosi and other progressives seem oblivious to the fact that some 40% of Americans consider themselves conservative, versus 25% or so whom identify themselves as progressives. Rasmussen and other pollsters show a continuing dissatisfaction with both the Congress and the direction that the nation is headed, under the Democrats (some 60% or so disagreeing); the Democrats, under a slumping economy and the health care kerfuffle, have steadily been eroding their advantage in a generic ballot horse race to the point a couple of RealClearPolitics-tracked pollsters now show a narrow advantage to Republicans.
This trend is occurring despite the best efforts of Obama and his progressive cronies to paint the Republicans and conservative Democrats as unconstructive opponents in state of denial regarding the need for "reform". In fact, we conservatives do believe in reforming health care. Obama and his propagandists want to present to the American people a false dichotomous choice, defining "reform" as some ill-defined, seat-of-the-pants set of mutually inconsistent proposals being pursued in the House and Senate, with only 3 moderate Senate Republicans having an input in discussions. Conservatives have discussed reform, not in some megalomaniacal Obamaian delusion to manage sector costs, but do deal with specific problems through relevant reforms, e.g., catastrophic health insurance to deal with problems of insurance caps and the rise of household bankruptcies due to medical costs; assigned risk pools to deal with preexisting issues (where risks of higher-cost patients are spread fairly across insurers and the government), and deregulation of health insurance marketing across states, without having to deal with expensive mandates (such as allowing people to start insurance on a day they seek medical treatment) which constitute barriers to entry, medical malpractice tort reform, and improved information and accessibility to available providers and medical service/drug prices.
Obama himself is ignoring the message of his declining poll numbers, as White House Press Secretary Robert Gibbs seemed to suggest, that Obama was willing to sacrifice a possible second term in office over this still not fleshed out health care "reform".
Concluding Thoughts
Obama is dismayed, seeing his approval numbers drop, public polls showing popular sentiment now against his "reforms", not just conservatives, but independents and moderates and blue dogs: Oh my! (Just follow the red brick road...) He's baffled--he thought it all figured out: the reason that health care "reform" in 1993-1994 failed was because of the Clintons' mismanagement of the issue. Obama was smarter and politically savvier than the Clintons; he would avoid the political risk inherent in providing his own solution, let politically invulnerable progressive Congressional Democrat leaders do the heavy lifting and continue his campaign-proven Teflon-style masquerade as a political moderate in cheerleading reform.
But America is hungering for leadership instead of an ongoing political campaign now well into its third year; in addition to Bush bashing, Obama is running against private sector health care insurer "greed", a single cable news outlet, and conservative radio hosts for sabotaging "reform"; all of that, of course, outweighs the liberal mass media's uncritical cheerleading for Obama's political agenda and the fact that progressives are outspending conservative critics by better than 2-to-1 in media ads. [We have seen a typical response by the media by trying to portray dissidents to "reform" as wackos, e.g., highlighting one townhall critic's characterization of the reform as "Nazi" or David Gregory's recent focus in Meet the Press on a solitary protester wearing a Thomas Jefferson quote (which Gregory intentionally linked to domestic terrorist Timothy McVeigh). The quote basically encourages people to speak up when they see the government doing something wrong--perhaps like the unnecessary government intervention into health care.]
After all, Barack Obama is the One, the Pied Piper of Failed Liberalism, and made sure that government-bred pig was wearing just the right shade of deficit-red lipstick... He continues to "educate" the people (because they need the government, which can't balance its own budgets, to manage the health care sector's share of the economy). The White House continues its outrageous assault on American liberty, seeking to intimidate legitimate debate and dissent by having encouraged the reporting of anti-interventionist "fishy" emails: No doubt that Barack Obama wants to be your Big Brother and may one day suggest, as some rogue regimes have, that children have a patriotic duty to inform on their parents (e.g., alternative medical approaches not yet sanctioned by government bureaucrats). To paraphrase William Shakespeare, "something is rotten in the District of Columbia."
