President Obama, Speaker Pelosi, the
Democratic Party, and our friends on the left side of the Mirror of Justice
community understandably are in a celebratory mood. I wish that I could
join them. As the House of Representatives enacted his health care agenda
by a thin margin, President Obama said: “In the end, what this day represents
is another stone firmly laid in the foundation of the American dream.”
Oh, would that it were so!
I instead find myself deeply
depressed about the lost opportunity to establish access to quality health care
on a stable foundation, about the considered drag on a weakened economy imposed
by a government- and regulatory-heavy bill, about the huge debt burden that
will be left to our children by a fiscally reckless approach, about the
impoverished economic opportunities and the decline in health care choices that
will be available to my daughter and future generations of Americans, and about
the uncertain future for genuine health care reform.
For those who have supported this
legislation on the Mirror of Justice, I recognize that they admirably see in it
the promise of greater access to health care for millions of Americans
presently unable to afford health insurance and greater security in health care
coverage for those who presently have health insurance. With our shared
Catholic commitment to the human dignity of every person as created in the
image of God, we all earnestly hope for the availability of quality health care
for everyone in our society.
But, sadly, I conclude that the
flawed and precarious legislation enacted this past weekend turns the promise
of quality health care for all into a hollow hope. I fear that the
prospect for sustainable health care reform is even more fragile than it was
last week. My hope now is that, as the weaknesses in this bill become
manifest over the next few years and as the reckless risks taken by this
irresponsible approach begin to be realized, we will find a way to salvage the
promise of genuine health care reform. My fear is that we are more likely
to simply abandon the effort out of exhaustion.
After staying up past midnight on
Sunday to hear some of the debate and watch the final vote tallies in the House
of Representatives) , I confess to feeling fatigued and saddened (and not just
because it was past my bed-time on a school night).
I was astounded that
the party which calls itself “Democratic” was so intent, indeed openly proud,
to ram through a narrow partisan approach to a major social problem without any
hesitation or reconsideration and over the opposition of nearly 60 percent of
Americans (CNN poll pdf here).
I was disappointed that
President Obama and Speaker Pelosi made the audacious determination to enact
the most liberal (that is, the biggest government) health care bill for which
they could assemble a slender majority through party pressure, cajoling, and
back-room deals (here and here). In so doing, President Obama
squandered the unusual opportunity offered by the political upset in the
Massachusetts Senate race to instead frame a stable, fiscally responsible, and
politically inclusive set of policies with a better chance to succeed in the
long-run.
Over the past few weeks, we have had
a robust debate on the Mirror of Justice about the meaning of the health care
legislation for the sanctity of unborn human life. In my view, aside from
the doubtful protection against use of taxpayer funds directly or indirectly
for abortion, there is only one other thing wrong with the Democratic health
care legislation — just about everything else in the bill.
To continue this debate, to ward off
the fatigue, and to invite responses arguing that I am wrong, I plan to offer a
series of posts over the new few days, with comments turned on starting with
tomorrow’s dispatch. In these posts, I will submit that the enactment of
Obamacare by the Democratic majority in Congress was not a promising beginning
to health care reform.
Having said that, I understand the
reaction of many readers of Mirror of Justice exclaims: “Arghh!!!
What do you mean by the ‘beginning’ for health care reform?” Aren’t
we finally at the end of the partisan wrangling, procedural
gamesmanship, and mind-numbing debate? Can’t we finally move on to other
public business?
To be sure, President Obama and
Speaker Pelosi triumphantly announced Sunday’s vote in the House of Representative
as culmination of a century of efforts to enshrine quality health care coverage
as a basic right for all Americans. In his typically self-reverential and
rhetorical excess, President Obama declared last September to a joint session of
Congress: “I am not the first president to take up [the health care]
cause, but I am determined to be the last.”
What nonsense. There never was
any chance that the complex and constantly evolving set of policy, political,
economic, and technical issues surrounding access to health care could be
magically resolved for all time by a single piece of legislation enacted by any
political party in any particular year. In fact, the legislation enacted
by the Democratic Congress on Sunday and signed into law today by President
Obama is so defective that it guarantees that the health care mess will be
passed on to the next Congress and the next President and the next generation (here).
Speaker Pelosi admonished the
American people that “ we have to pass the bill so you can find out what is in
it” (video here) We have arrived at that
day. And, as the attentive knew in advance, the most significant elements
of this legislation do not take effect for months or years and remain
contingent on a series of future actions (read: yet more political votes)
by Congress over the next several years.
Consider just a couple of
examples: The extension of government-run health care to millions more
Americans does not go into effect until 2013 and assumes that future Congresses
facing unpredictable political and economic circumstances will carry through on
appropriations bills to fund the program. Likewise, the half-a-trillion
dollars in cuts from Medicare that are to be used to subsidize universal health
care coverage will have to be sustained by future Congresses, a prospect that
is dicey at best.
Moreover, public opposition to this
health care legislation — which was at a two-to-one margin on the day of
enactment — is likely to grow as the regulatory impact of the bill begins to
hit home with increased premiums for health insurance, as employment numbers
continue to be sluggish because employers are worried about the additional
costs of new government edicts, as higher taxes on investment slow the economic
recovery, and as the specter unfolds in the news media of tens of thousands of
newly-hired Internal Revenue Service investigators trying to impose thousands
of dollars in fines on mostly young adults who fail to obey the federal mandate
to buy health insurance. As the outcry rises, elected politicians are
likely to respond by trimming back, postponing, creating exemptions, etc.
And thus the house-of-cards known as
Obamacare may collapse.
So, yes, we are at the beginning of
health care reform, and the time for a victory lap is not yet arrived. Sadly, I believe this beginning step was so poorly-designed and
economically and politically unrealistic that genuine health care reform may be
smothered by future events and contingencies.
As I’ll suggest in a series of posts
over the next few days , I submit there are three basic and fatal flaws in the
Obamacare legislation:
First, the program and policy
choices made by President Obama and the Democratic majority in Congress,
focused as they are on government as the primary actor to offer and manage
health care and failing as they do to address the most pressing problem of
rising costs, were foolish, slanted, and imprudent.
Second, because the fiscal
implications of the health care legislation depend on future difficult actions
that Congress is unlikely to take and because the legislation recklessly and
needlessly sinks the nation deeper into national debt, the legislation will not
prove economically viable.
Third, because President Obama and
the Democratic leadership forced their preferred legislative vehicle through on
a party-line vote and over the opposition of a majority of citizens, the health
care legislation will not be politically sustainable in the difficult years to
come.
For this exchange, I'll turn on the comments. At the least, through this exchange,
maybe we'll all be better informed about why we celebrate or mourn. And
maybe I’m wrong so that other members of the Mirror of Justice or readers will
give me reason to turn my frown into a smile.
As Ross Douthat writes in the New
York Times (here):
[The liberals who supported this
bill make] an assumption straight out of the golden age of ’60’s liberalism —
that a bill this costly, this complicated and this risky can be made to work,
so long as the right people are in charge of implementing it.
As
a conservative, I suspect they’re wrong. But now that the bill has passed, as a
citizen of the United States, I dearly hope they’re right. Indeed, I hope that
20 years from now, in an America that’s healthier, richer and more solvent than
today, a liberal can brandish this column and say “I told you so.” Because the
alternative would mean that we’re all about to be very sorry, and for a very
long time to come.
“Experience
keeps a dear school,” Ben Franklin said, “but fools will learn in no other.”
Whether liberals or conservatives are the fools in this story remains to be
seen. But school will be in session soon enough.
Greg Sisk
