Sunday, September 20, 2009

Health Care: I'm ready to declare a Republican victory.

I don't write these words often: The Republicans are correct. Today I listened to Meet the Press and was very disheartened. As a firm believer in the superiority of single-payer and, dare I say it, socialized medicine, I have to agree with the Republicans on the show who asked that Obama "hit the reset button" and start over. Because I've read all about the Baucus Bill and the bills going through the house, and even though we don't know exactly what shape the final bill will take, the Republicans are right to say it won't live up to Obama's core principles.

Now, to be clear, I don't think Republicans believe in or desire to reach Obama's core principles. When he says he wants everyone covered, I think they agree only in so much as they want everyone to buy over-priced, deeply flawed health insurance plans. When he says he wants it to be deficit neutral, I think they love the idea, as long as it involves no tax increases or cuts to any of their programs. Mostly, I think they love the fact that he's voice standards he can't meet, so they can say he's a failure because he's produced growth in the size of government and higher national debt, two things they had absolutely no qualms about when they had the presidency and both houses of Congress. "Please, Mr. President," I hear them whisper, "keep articulating the virtues of fiscal discipline as a nod to Republicans, so we can rake you over the coals if you do the very things we did when we had the chance."

Yes, I think there is some cynicism on the part of the Republicans in Congress, but I also think there's some genuine ideological motivation. They may not have cared about their ideals before, but they do now. Fine. The sad fact is, they're right even when they're wrong. I think they're wrong that government is this perpetually evil entity that wants to swallow us alive. They're wrong that health care is somehow fundamentally different than clean drinking water or police protection or fire fighters or national security. They're wrong when they claim the free market produces the best results in all spheres of life, including health care. They're even wrong when they say the American people don't want the government to be involved in health care, or to have a public option. But they're absolutely right when they point out that there's a disconnect between what Obama wants, and what these bills would provide.

Which brings me back to my biggest frustration with the Democratic Party. Republicans may not hold views I agree with, but they hold them more strongly than the Democrats. In fact, I believe Republicans hold views that less than half of the country shares, to the extent that they wouldn't be able to win elections based purely on abstract policy debates. But elections aren't abstract policy debates, and whenever Americans are feeling even the slightest bit squeemish, they look to the party that projects confidence, consistency, and strength. John Kerry, I believe, didn't lose the presidential election of '04 because he couldn't win over enough people who were really engaged in the issues. He lost because there are a lot of people in the middle who picked up on the flip-flopper meme and didn't understand, or care, about the ins and outs of procedural votes in the Senate. They wanted consistency, they saw the terror alerts bobbing up and down, they heard rumors of hints of terrorist chatter, and they stuck with the guy who never wavered, even when they didn't agree with him or even particularly respect his intelligence or character, because they admired his single-mindedness.

President Obama is not stupid. I'm sure he knows this. Playing cool and collected helped him in the campaign, when McCain was acting erratically, making a desperate choice for VP, botching questions, and wavering when faced with over-the-top hecklers. But Obama didn't want to make the Clinton mistake of ramming something through Congress, so he tried to split Solomon's baby and stick to explicit principles while turning the details over to the Dems in Congress.

But instead of tacking to his left, giving him something he can sign in a heartbeat, they've tried to find the middle. Which is a problem when the other side knows that if you just stick to your position, the middle keeps moving your way. The Republicans don;t bother trying to find middle ground. Why should they? If they stay firmly on the far-right, the middle, between Blue Dogs and other folks who are concerned about being from genuinely competitive districts, moves in their direction. The Dems need every Democrat from some gerry-mandered district or safe senate seat to hold just as fast to the left as the Repubs do to the right. Then let the Blue Dogs and the senators from Maine craft something decent, and the other Dems can vote for it, looking as reluctant as they want, and some Repubs will do the same, and Obama gets his victory. Instead, the Dems have crafted something no one likes, and the Republicans don't have to budge because they know there aren't going to be enough Dems to pass it. I genuinely believe it's an issue of party discipline. The Dems have crafted crap in an effort to find middle ground, rather than crafting something ballzy and forcing the Republicans to take a stand on it one way or the other. Great strategy, Democrats. "What, do you dare stand in opposition to crap?" they shout across the aisle. "Yes, we're opposed to crap," Republicans say with confidence.

So we will get the status quo, which is worse than crap. Without genuine health care reform, the dangerous cost of the various bills in Congress now will look paltry compared to the effects on the over-all costs of not doing anything. Think a 1% tax on people making over $250,000 sounds bad for the economy? Wait until, as the Business Roundtable (not a liberal group by any stretch) predicts, health insurance costs $28,000 per employee. Think your business will offer you that? Think manufacturers will still want to employ anyone here?

If the Democrats had some cajones, they would have proposed a dramatic change to the national health care system, taking it out of the hands of employers and creating a generous safety net, with choice left in for people who wanted health insurance that covered things beyond the scope of government-provided care. What would have happened? Business would have likes it. Doctors and nurses would have likes it. Hospitals would have liked it. Insurance companies would have hated it. Libertarians would have raged. Fringe groups would have freaked out, marching on Washington with angry signs, many of which would contain over-the-top statements about other issues entirely and some of which would even have had ugly racial slurs. Fox News and their ilk would have railed against it. Republicans in Congress would have flatly refused to play ball. But a couple of them would break ranks because they wouldn't want to be on the wrong side of history, or wouldn't want to face the consequences if it were a success, and that would have been enough to pass it.

Instead, here's what I see happening: The Dems try to produce a by-partisan bill which makes as little change as possible to the current system. Businesses are luke-warm. Doctors and nurses like it. Insurance companies hate it. Libertarians are enraged. Fringe groups have freaked out and marched on Washington with angry signs, many of which contained over-the-top statements about other issues entirely and some of which even had ugly racial slurs. Fox News and their ilk have railed against it. Republicans in Congress have flatly refused to play ball. And now, after all that, some liberals will peal off because the plan isn't far enough to the left, and they don't want to face the consequences if it's a dismal failure to do the things the vast majority of Americans agree it should do. So it won't pass.

This is Democracy at its best and worst. As I've said before a million times: Democracy is the best system of government ever devised for giving people exactly the governance they deserve.

So, here's my prediction. Democrats will put some very bad legislation on President Obama's desk, if they can get it there, and he'll hold his nose and sign it, and the Republicans will declare victory. Or the Democrats won't even be able to shovel their bill onto Obama's desk, and the Republicans will declare victory. Because they're right about the bill. They are correct. They win.

And America loses.

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