Health Care: The Next Battle

December 24th, 2009 at 9:28 am | 52 Comments |

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From a legislative perspective, it’s not over until the Presidential pen comes out at the signing ceremony.

And, yes, it is possible that Obamacare will still run into turbulence.  Conservative blogs overflow with reasons why this could all fail.  To review: Democrats in the Senate and the House disagree about a slew of important details from taxes to the public option; abortion is still a sticking point; and, complicating matters, Congress is unlikely to conference and vote on final legislation before February – plenty of time for plenty of problems to emerge.

But, for once, I accept the White House spin.  They have the ball and it’s on the one-yard line, to paraphrase Press Secretary Robert Gibbs.

Let’s be clear: there are those in Washington who have serious reservations about the size, scope and cost of the health reforms being debated.  They are called Republicans, and they are the minority in both the House and the Senate.

With today’s vote, the remaining task for the White House is relatively small: to smooth over the House-Senate policy differences and round up votes, as they have done before.  The President is on his way to Hawaii; his reforms are on their way to law.

The coming political achievement is incredible.  The White House gambled big – and looks likely to pass the most sweeping healthcare legislation in more than four decades.  Republicans and conservatives will need to do some soul searching and attempt to answer a gut-wrenching question: how did we lose this?

But, in terms of policy, the victory is not quite so complete.  For much of this year, the President spoke of health reform beginning with the 25th holder of his office. “It has now been nearly a century since Theodore Roosevelt first called for health care reform. And ever since, nearly every President and Congress, whether Democrat or Republican, has attempted to meet this challenge in some way.”

In September, when addressing Congress, he added:  “I am not the first President to take up this cause, but I am determined to be the last.”

Much work remains to be done.  The Senate bill that passed today leaves many details to be filled in later.  More importantly, the biggest task remains: how to bend the cost curve in the coming years.  As I’ve noted before, if anything, Obamacare will worsen the problem of health-cost inflation, not tame it.

The President hopes to be the last President to take up this cause.  Nonsense – the challenge of paying for a modern healthcare system with an aging population has not been fundamentally resolved today, nor will it be resolved with this presidency.  The debate continues.

Let’s then return to Gibbs’ analogy.  The ball is on the one-yard line, but it’s still the first quarter.  Those of us who favor market reforms are on the defensive.  But there is much football ahead to be played.

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52 Comments so far ↓

  • athensboy

    As much as Limbaugh says “its the end of this nation” everyone with a brain knows the gop cries wolf on everything Obama and the Democrats do. People trust the gop even less than they trust Democrats. The gop is the party of know. Too me they are like a child that whines all the time. After a while you just tune them out. The gop had a chance to reform healthcare when they had power, they punted and instead gave tax breaks to the uber wealthy. Nothing the Democrats do would please them, they have quit trying to be part of the solution.

  • WillyP

    mlindroo says:
    “Maybe there are some cases that I have not thought about, but it seems to me that the most successful civilizations are the ones that constantly reinvent themselves (e.g. the Western world from the 15th century onwards) whereas the ones that don’t adapt — the Chinese empire, for example — fall from power sooner or later.”

    If you go back to the Roman times, you’ll find that the tax system eventually led to serfdom – it tied people to the land, making sure they paid their taxes or else, so that Caesar could fund the military. Yes – it was taxes that created serfdom. Yes – it is socialism that represents the model of 100% taxation. And this, I surmise, is why Hayek titled his warning against socialist planning “The Road to Serfdom.)

    What about all those Acts passed in Great Britain before the American Revolution? Take the Navigation Acts and the Molasses Act. Were these not championed as reform movements? Surely, they were popular in Britain because they safeguarded British shipping interests through a program of prohibition (of continental shipbuilding) and subsidy (through tariffs). Yet clearly the colonists were not so impressed by these reforms.

    Beethoven wrote Symphony #3 with Napoleon in mind, only to later realize that the man was primarily interested in self aggrandizement through war and conquest. He was popular at the time, and the population proved itself naive trusting such a man.

    Many disaffected aristocrats were openly sympathetic to socialism; indeed, even championed its cause. Marx and Engels were unquestionably “bourgeois.” J.S. Mill wrote elegantly about the promise of socialism. Good intentioned and bad, both Mill and Marx were wrong about socialism.

    But we need not go back that far. Many Western intellectuals looked abroad to Fascism as a great step forward for mankind. W.E.B Dubois and H.G. Wells were both in awe of the European strongmen of the 20th century. So, as a matter of fact, was J.M. Keynes (or at least appreciated their economic system, which consisted of planning from atop).

    FDR was extremely cynical in promoting his Social Security scheme. He sold it to the people as “insurance,” and to the Supreme Court as just another tax (when they challenged his claim that it was actually “insurance”). He knew it was destined for cyclical bankruptcy, that it was not a stable and self-perpetuating program. So he told that court, Look, I know as well as you do that this really isn’t insurance. But I need revenue, and this is unarguably another source of revenue. Later generations can clean up my mess. And, by the way, it gives my party a big electoral advantage!

    Keynesianism represents another fork in the road for intellectuals. Eminent economists of the day, including Paul Samuelson and Lionel Robbins, came to regard government interventionism as the purpose of economic advisory (Samuelson later “wrote the book.”) They did this while bucking ~200 years of established wisdom, and never refuting arguments they previously held to be true.

    So the history of mankind is not, as we’d like to believe, only upwards and onwards. Many times we turn down dark alleyways and don’t realize it until it is too late. Eugenics, remember, was once a respected “science” as well.

    In the context of the current healthcare debate, the point is this: central planning does not work because it cannot work. It has failed in the past, and will fail in the future. Any so-called reform that involves centrally planning resource allocation is regressive. We’ve known this, in theory and in practice, for almost 100 years now, and yet the supposedly enlightened GOP moderates don’t quite get it. I have no patience for such ignorance, and I wish you’d all wise up… and fast.