Sunday, March 21, 2010

A health care retrospective

A few lowlights from the sordid tale of health care reform:
  • Health care lobbyists played a significant role in shaping the legislation. For all of President Obama's verbal broadsides against the insurance companies, the ultimate result was a bill which requires all Americans to purchase their product. The expansion of competition through interstate sales, meanwhile -- which would have actually put health insurance companies under pressure -- was always off the table.
  • Candidate Obama promised that health care negotiations would be broadcast on C-Span. Suffice to say that never happened.
  • When concern was raised over votes taking place on key pieces of health care legislation before members even had a chance to read the bills, Rep. John Conyers responded by wondering aloud what the point of even reading the bills was.
  • A series of payoffs was dispensed to individual legislators, perhaps none more notorious than the Cornhusker kickback secured by Sen. Ben Nelson.
  • Speaker of the House Nancy Pelosi declared that her preferred method for health care reform approval was to "deem" it pass without actually voting on the bill itself. This was only short days after she hilariously said health care had to be passed so that people could find out what's in it.
  • The Congressional Budget Office scoring system was thoroughly gamed. There is no "doc fix" built in and some of the taxes meant to pay for reform aren't scheduled to kick into effect for years down the road, which realistically means they won't come into being. Plus there's the fact that while a number of taxes begin immediately, benefits won't start for several years (strange, given the oft-heard rhetoric about how reform is needed post-haste to literally prevent people from dying).
  • President Obama bizarrely told the American people that a 2,300+ page bill of new taxes and regulations which mandate every citizen purchase health care insurance would give them, rather than government or health insurance companies, more control over their health care.
  • Rep. Alcee Hastings' revealing statement that the House, during its consideration of health care reform, was making up the rules as they went along.
What's darkly amusing to me is that for all of the hype and promise about bringing "change" to Washington and altering the way our government does business, the manner in which the Democratic Congress has conducted itself recalls the last major expansion of government intervention in health care seven years ago under GOP leadership, through passage of the Medicare drug prescription benefit bill:
The bill was debated and negotiated for nearly six years in Congress, and finally passed amid unusual circumstances. Several times in the legislative process the bill had appeared to have failed, but each time was saved when a couple of Congressmen and Senators switched positions on the bill.

The bill was introduced in the House of Representatives early on June 25, 2003 as H.R. 1, sponsored by Speaker Dennis Hastert. All that day and the next the bill was debated, and it was apparent that the bill would be very divisive. In the early morning of June 27, a floor vote was taken. After the initial electronic vote, the count stood at 214 yeas, 218 nays.

Three Republican representatives then changed their votes. One opponent of the bill, Ernest J. Istook, Jr. (R-OK-5), changed his vote to "present" upon being told that C.W. Bill Young (R-FL-10), who was absent due to a death in the family, would have voted "aye" if he had been present. Next, Republicans Butch Otter (ID-1) and Jo Ann Emerson (MO-8) switched their vote to "aye" under pressure from the party leadership. The bill passed by one vote, 216-215.

On June 26, the Senate passed its version of the bill, 76-21. The bills were unified in conference, and on November 21, the bill came back to the House for approval.

The bill came to a vote at 3 a.m. on November 22. After 45 minutes, the bill was losing, 219-215, with David Wu (D-OR-1) not voting. Speaker Dennis Hastert and Majority Leader Tom DeLay sought to convince some of dissenting Republicans to switch their votes, as they had in June. Istook, who had always been a wavering vote, consented quickly, producing a 218-216 tally.

In a highly unusual move, the House leadership held the vote open for hours as they sought two more votes. Then-Representative Nick Smith (R-MI) claimed he was offered campaign funds for his son, who was running to replace him, in return for a change in his vote from "nay" to "yea." After controversy ensued, Smith clarified no explicit offer of campaign funds was made, but that that he was offered "substantial and aggressive campaign support" which he had assumed included financial support.[12]

About 5:50 a.m., convinced Otter and Trent Franks (AZ-2) to switch their votes. With passage assured, Wu voted yea as well, and Democrats Calvin M. Dooley (CA-20), Jim Marshall (GA-3) and David Scott (GA-13) changed their votes to the affirmative. But Brad Miller (D-NC-13), and then, Republican John Culberson (TX-7), reversed their votes from "yea" to "nay". The bill passed 220-215.
The more things change, the more they stay the same I guess. The Democrats have essentially become that which they swore to defeat.

Other thoughts: I feel slightly foolish for thinking it could have turned out any other way. For all the talk about pro-lifers and fiscal conservatives within the Democratic ranks, we all know that Democrats prize expanded government intervention in health care above almost all else. Deep inside their hearts, those who initially wavered in supporting the bill wanted to vote for its passage. They only needed a fig leaf to conceal their statist ambitions. Those who cited concerns about fiscal responsibility were handed an absurd CBO score as cover. The pro-lifers were given an executive order of debatable import from a firmly pro-choice president, the impact of which will cease as soon as he departs from office.

The silver lining? Well, I think Nancy Pelosi won't be Speaker of the House come this time next year. Democrats just passed a massive expansion of the welfare state on a party-line vote which went against the wishes of the American people. Opposition runs so deep that many thousands turned out in opposition to the health care bill in protest on Capitol Hill for a rally organized only days beforehand. Others, unable to make it to Washington, held protests of their own across the country which attracted hundreds. The Capitol switchboard reported 100,000 calls per hour in the week leading up to the vote. Last year's Tea Party rally on September 12 attracted tens, if not hundreds, of thousands.

Plainly this is an electorate which has been stirred, and Democrats should be prepared to reap the whirlwind. They will pay a heavy price this November.

Then again, so what? After all, this bill isn't about political victory in the fall, it's all about the long game and another massive encroachment of the state which will not easily be undone. Even if the House votes for repeal, the Senate would likely filibuster. If a bill to scrap ObamaCare were to somehow emerge from Congress it will face a veto. The only way to truly undo this disaster lies with a GOP Congress and President which would take power in 2013 at the earliest, something that is far from assured. Given the questionable commitment of the Republican party to limited government while in power, even this trifecta would guarantee nothing.

Scott Grannis believes today's vote serves as the high-water mark for big government. Reluctantly, I am more pessimistic.

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