Health care Armageddon fallout
After such a bruising, intensive, drawn-out battle over one of the biggest public policy issues in American history, it was inevitable that nerves are raw, and many people on the losing side are angry and resentful. I am no exception. Temperamentally and emotionally, I am sick (!) to my stomach with rancid partisan bickering, having been caught up in the fray. I would like nothing more than to step back from partisan politics and build bridges of understanding as the first step toward establishing a broader consensus on health care policy, compromising in some areas while upholding the core principles of liberty and individual responsibility.
Whether the political atmosphere cools down in the weeks and months to come, thus permitting a moment of calm breathing space for our weary nation, will depend to a large degree on President Obama himself. Accordingly, we should all pay close attention to exactly what he says when he tours the country to try to convince the skeptical American public that the new law is in their best interests. It was not a good sign that when the President signed the first portion of the bill a few minutes ago, not a single Republican was present at the White House ceremony. (His remarks are posted at whitehouse.gov.) Presuming the Senate passes the House's reconciliation package, that portion will be signed next week.
Some Republicans are already talking about repealing the bill, but that is a complete waste of time. From a political standpoint, it's a done deal, period. Our side lost. Even if the GOP takes back both houses of Congress in this fall's elections, there is no way that they could override a presidential veto. In terms of a legislative remedy, we will have to wait three more years, and by that time, people will have grown accustomed to the new system, even though its full provisions will not have kicked in by then. It was not for nothing that the cover of Newsweek magazine's February 16, 2009 issue proclaimed, perhaps just a bit prematurely, "We are all socialists now."
For want of any realistic legislative remedies, therefore, the only way to correct the mistake before it is too late is through the judicial branch of government. During an interview with Greta Van Susteren on Fox News last night, Virginia Attorney General Ken Cuccinelli said he would file a lawsuit challenging the constitutionality of the health care bill in the Fourth Federal Circuit Court of Appeals, located just across the street from his office in Richmond. Among other things, he cited the violation of the Tenth Amendment to the constitution, which reserves to the states powers not expressly delegated to the Federal government. For more on that issue, see my Feb. 27 blog post. Thanks to Ryan Setliff for calling attention to the logo from the Tenth Amendment Center.
Some experts dispute the validity of that approach, including Prof. Timothy Jost of Washington and Lee University, who was on C-SPAN on Monday morning. He seemed like a reasonable, even-handed legal authority, but almost as soon as he started talking I knew something was wrong. Basically, he argues that past Supreme Court interpretations of the Constitution are etched in stone, so there is no legal foundation whatsoever for the effort by states to block implementation of the health care legislation. If that seems like an extreme position, it merely reflects his long-standing role as a leading advocate for the Democrats' push for health care nationalization. (NOTE: Contrary to what it says on the C-SPAN Web site, the Commerce Clause is not part of the Tenth Amendment; it is actually part of Article I, Section 8.) Here are some key passages from Prof. Jost's appearance on C-SPAN, which include some very troubling statements:
And so one thing the legislation does is that it says that if you can afford health insurance, you should buy it. I refer to this as the 'slackers' provision, because what it says is everybody is responsible for insuring themselves, just like if you drive a car you're responsible for getting car insurance.
Under the Supremacy Clause, a state cannot tell the Federal government what to do. Federal law is the supreme law of the land as long as Congress is acting within its Constitutionally granted powers, and it is here.
So basically, the law now is, that if there is any kind of economic activity involved, Congress has the power to regulate it. And of course, Congress does.
What the Supreme Court has often said is that where economic activity is involved, economic or social activity, Congress need merely show that its laws have a rational relationship to a legitimate governmental interest for them to be constitutional.
Now let me point something out, because a lot of people don't know what's in this law [sic] other than what they have heard on Fox News...
At that point, I turned off the TV in disgust at his flagrant bias and dangerously statist (if not totalitarian) philosophy. From watching the Web video, however, I learned that he went on to claim that the health care bill (which he prematurely called a law, before it had been signed!) "is based on basic Republican principles." He also asserted that states themselves have no legal right to challenge the constitutionality of Federal laws, only individuals who are adversely affected do. And since the individual insurance mandate does not go into effect until 2014, he says, there can be no legal challenge until then. (Is that why they postponed implementation of the mandate, to make in immune from legal challenge? How clever!) If that is how the Supreme Court sees things, then we really are "screwed, blued (!), and tatooed."
It will soon become apparent that there are a few more loose ends that need to be tied up. First and foremost, how will the administration retain the services of physicians even as Medicare and Medicaid funding is slashed? That's what the controversial "doctor fix" is all about. Millions of people will be dismayed to learn that the CBO estimates that enacting H.R. 3961, by itself, would cost about $208 billion over the 2010-2019 period, adding substantially to the budget deficit. As noted by AllahPundit, the CBO response to Rep. Paul Ryan is very clear and unequivocal:
You asked about the total budgetary impact of enacting the reconciliation proposal (the amendment to H.R. 4872), the Senate-passed health bill (H.R. 3590), and the Medicare Physicians Payment Reform Act of 2009 (H.R. 3961). CBO estimates that enacting all three pieces of legislation would add $59 billion to budget deficits over the 2010-2019 period.
Original document: cbo.gov. NOTE: Republicans were circulating what was alleged to be an internal Democratic memo instructing its members not to talk about the doctor fix, but Democratic leaders challenged the authenticity of the memo, so politico.com removed it, pending confirmation. (Link via Mud Pit.)
Facebook friend Andrew Murphy, one of the few people I know who is familiar with Richard Hofstadter's writings on pseudoconservatism, pointed out that the actual provisions of the health care bill aren't really that radical. I responded:
That's correct, in terms of substance, all the bill does is take a totally dysfunctional system and expand its scope to include nearly everyone. Democrats know this, which is why I think it's only an intermediate step toward a public option, and eventually a nationalized single-payer system.
So, just let me just make clear, the Health Insurance Reform Act of 2010 does not signify the imminent arrival of national socialized medicine. It is, rather, a watered-down compromise that no one seriously believes can be sustained for very long, thus setting the stage for an inevitable progression (!) toward socialized medicine. It will happen so gradual that hardly anyone will notice, like the frog in the pot of water that slowly comes to a boil.
Will Democrats suffer political retribution in November? In today's Washington Post, Dan Balz summarized the electoral prospects for members of Congress from both parties in the wake of the health care vote. It's not just Democrats at risk, it's also Republicans whose "no" votes will anger a certain portion of their constituents. As a supplement to that article, there is a great map of the U.S. showing the various situations House members find themselves, in the finest tradition of Edward Tufte. (He's the author of the classic work, The Visual Display of Quantitative Information.)
Virginia Rep. Thomas Perriello is among the incumbents in "marginal and conservative-minded districts" whose jobs are most at risk, according to politico.com. Perriello issued a statement last week to the effect that he would vote "yes" on condition that the Senate would accept House provisos. But since the Senate will not vote until after the House votes, it was a meaningless gesture. I think Perriello figures he probably can't win reelection, no matter what he did, so he went ahead and became a willing sacrifice on the altar of Obamacare.
Even though many Republicans are all fired up about defeating pro-Obamacare Democrats in this fall's elections, David Frum thinks they have already lost the decisive battle. He makes a point I raised January 9, that the transformational effect on the American political landscape make it worth it for the Democrats, even if they lose control of Congress. From youtube.com:
What happens today is a bigger defeat for Republicans than any gains in the midterms can offset. ... Going for the political win we achieved a permanent policy change.
In the New York Times, Paul Krugman (the very epitome of a smug liberal elite ) wrote that the Republicans failed because of their crude fear-mongering tactics. I would agree that some of the opposition to Obamacare was unduly harsh, and they should have distanced themselves from the Tea Party protesters (or possible leftist infiltrators) who shouted racist epithets at African-American legislators. Krugman lauded Obama's upbeat quote from Abraham Lincoln: "We are not bound to win, but we are bound to be true." (From my perspective, it appears that the opposite is the case, but what do I know?) Krugman denounced the "callous cynicism" of Republican opponents, somehow ignoring the vast body of serious, intellectual research which calls into question the workability and fiscal sustainability of centrally-managed national health care. He's just being very selective about the use of evidence, and in that sense is no different than many of Obama's more vociferous critics. He is right, I'm afraid, about one thing: "proposals to guarantee health insurance are often controversial before they go into effect -- Ronald Reagan famously argued that Medicare would mean the end of American freedom -- but always popular once enacted." That quality of irreversibility is precisely why the government should refrain from enacting such entitlements in the first place!
On a more humorous note, Rush Limbaugh said he would move to Costa Rica if Obamacare was passed (good choice! ), so now some Democrats are raising money for him to buy a plane ticket there. See politico.com.
One of my Facebook friends reacted to the passage of Obamacare by writing something about conservatives needing to take over the Republican Party, to which I replied:
Republicans in the House and Senate were unanimous in rejecting Obamacare. The problem is not that Republican office holders aren't conservative enough, it is that self-proclaimed "conservatives" have been so busy attacking other Republicans that the party has been left in a shambles, paving the way for socialist / Democrats to seize national power.
Result: That person removed the original statement. I hope that means the point I was making was properly absorbed. It pains me just how widespread such misleading ideas are in the Republican Party today, which is why the GOP has been plagued by a virtual civil war.
That is what I meant by the following post I made on Facebook a short time ago:
During the White House signing ceremony, President Obama forgot to pay respects to the one person who, more than anyone else, is ultimately responsible for the enactment of national health care legislation: George W. Bush.