House Ways and Means Committee Chairman Rep. Charles Rangel, D-N.Y.,
laughs as he is handed a copy of H.R. 3200,
America Affordable Health Choices Act of 2009,
as he stopped in on the House Energy and Commerce Committee
markup of the bill on Capitol Hill in Washington,
Thursday, July 30, 2009.
Rangel, who does not pay all of his income tax,
is eager to put a surcharge on everyone else's income tax
to pay the $1,300,000,000,000.00 cost of Obamacare.
(AP Photo/Susan Walsh)
My conservative friends
– and even a few media liberals –
The bloom is off the Obama rose.
He's not the Obamessiah,
just another 50 percent president.
He tried to do too much too fast, and his numbers are sinking.
The Europeanization of health care is dead.
I wouldn't be so sure. President Barack Obama has no choice but to move fast, in part because the image he presented during the campaign – a post-partisan, post-racial, post-anything-unpleasant-and-controversial pragmatic centrist – was a total crock. He has a vast transformative domestic agenda and, because most of its elements are not terribly popular, he has to accomplish it at speed or he won't get it done at all.
Health care "reform"? As we've seen this past week in the House of Representatives, put not your trust in "Blue Dog Democrats." And, as we'll no doubt see in the weeks ahead in the Senate, put not your trust in "moderate Republicans" whose urge to "reach across the aisle" is so reflexive it ought to be covered by the Americans With Disabilities Act.
The president needs to get something passed. Anything. The details don't matter. Once it's in place, health care "reform" can be re-reformed endlessly. Indeed, you'll be surprised how little else we talk about. So, for example, public funding for abortions can be discarded now, and written in – as it surely will be by some judge – down the road. What matters is to ram it through, get it done, pass it now – in whatever form.
If this seems a perverse obsession for a nation with a weak economy, rising unemployment and a war on two fronts, it has a very sound strategic logic behind it. As I wrote in National Review a week or two back, health care is the fastest way to a permanent left-of-center political culture. That's its attraction for an ambitious president: It redefines the relationship between the citizen and the state in a way that hands all the advantages to statists – to those who believe government has a legitimate right to regulate human affairs in every particular.
That's not why it's tanking in the polls, of course. It's floundering because Obama sold it initially on the basis of "controlling costs," and then the Congressional Budget Office let the cat out of the bag and pointed out that, au contraire, it would cost $1.6 trillion, and therefore either add to an unsustainable deficit, or require massive tax increases, or (more likely) both.
All of which is true. But to object to the governmentalization of health care on that basis implicitly concedes the argument that, if we could figure out a way to bring the price down, it would be fine and dandy. Right now, there are a lot of wonkish and utilitarian objections to what the Democrats want to do, and they're gaining traction. In The American Spectator, Brandon Crocker points out that this is exactly the way things went over Hillarycare in 1993: Americans took against the plan on practical grounds but not against the underlying principle. "Since we did not win that philosophical argument in 1993," Mr. Crocker writes, "we now have to fight the same battle today." And, if we win on utilitarian grounds today, we'll have to fight it again in 10 years, five years, maybe less – until something passes, and then everything changes, forever: As the IRA famously taunted Margaret Thatcher, we only have to get lucky once; you have to be lucky every day.
On the price tag: It's often argued that, as a proportion of GDP, America spends more on health care than countries with government medical systems. But, as a point of fact, "America" doesn't spend anything on health care: Hundreds of millions of people make hundreds of millions of individual decisions about what they're going to spend on health care. Whereas up north a handful of bureaucrats determine what Canada will spend on health care – and that's that: Health care is a government budget item. If Joe Hoser in Moose Jaw wants to increase Canada's health care spending by $500 drawn from his savings account, he can't: The law prevents it. Unless, as many Canadians do, he drives south and spends it in a U.S. hospital for treatment he can't get in a timely manner in his own country.
You can make the "controlling costs" argument about anything: After all, it's no surprise that millions of free people freely choosing how they spend their own money will spend it in different ways than government bureaucrats would be willing to license on their behalf. America spends more per capita on food than Zimbabwe. America spends more on vacations than North Korea. America spends more on lap-dancing than Saudi Arabia (well, officially). Canada spends more per capita on doughnuts than America, and, given comparative girths, Canucks are clearly not getting as much bang for the buck. Why doesn't Ottawa introduce a National Doughnut Licensing Agency? You'd still see your general dispenser for simple procedures like a lightly sugared cruller but he'd refer you to a specialist if you needed, say, a maple-frosted custard, and it would only be a six-month wait, at the end of which you'd receive a stale cinnamon roll. Under government regulation, eventually every doughnut would be all hole and no doughnut, and the problem would be solved. Even if the hole costs $1.6 trillion.
How did the health-care debate decay to the point where we think it entirely natural for the central government to fix a collective figure for what 300 million freeborn citizens ought to be spending on something as basic to individual liberty as their own bodies?
That's the argument that needs to be won. And, if you think I'm being frivolous in positing bureaucratic regulation of doughnuts and vacations, consider that under the all-purpose umbrellas of "health" and "the environment," governments of supposedly free nations are increasingly comfortable straying into areas of diet and leisure. Last year, a British bill attempted to ban Tony the Tiger, longtime pitchman for Frosties, from children's TV because of his malign influence on young persons. Why not just ban Frosties? Or permit it by prescription only? Or make kids stand outside on the sidewalk to eat it? It was also proposed – by the Conservative Party, alas – that, in the interests of saving the planet, each citizen should be permitted to fly a certain number of miles a year, after which he would be subject to punitive eco-surtaxes. Isn't restricting freedom of movement kind of, you know … totalitarian?
Freedom is messy. In free societies, people will fall through the cracks – drink too much, eat too much, buy unaffordable homes, fail to make prudent provision for health care and much else. But the price of being relieved of all those tiresome choices by a benign paternal government is far too high.
Government health care would be wrong even if it "controlled costs." It's a liberty issue. I'd rather be free to choose, even if I make the wrong choices.