July 24, 2009 03:45 PM ET
President Barack Obama's prime time press conference having done little to reassure a wavering public, it seems the Democrats hope to create a national healthcare system may once again have slipped out of out reach. The president agrees that his timetable has been thrown off and Senate Majority Leader Harry Reid, D-Nev., says they won't take up the issue before the recess despite the fact that he has a filibuster-proof majority of Democrats behind him. The committee process in the House has ground to a standstill, with the less liberal "Blue Dog Democrats" almost in rebellion against House Energy and Commerce Committee Chairman Henry Waxman, D-Calif., over the cost of the so-called tri-committee health care proposal.
Privately, the word is moving through Washington that the White House is prepared to abandon the idea of the public option that is causing so much concern, particularly in the medical community, which is not likely to endorse anything that leads to further federal price controls on healthcare.
Though House Speaker Nancy Pelosi, D-Calif., claims to have the votes to pass a package of legislation—and White House Chief of Staff Rahm Emmanuel insists Congress will vote on health care reform next week before it adjourns for the August recess—things look very bad, with the majority growing more desperate as the days pass.
A clear sign of their growing desperation is the way in which the Democrats are censoring the GOP's official communications to their constituents. On Thursday Roll Call reported the majority party is "preventing Republican House Members from sending their constituents a mailing that is critical of the majority's health care reform plan."
At issue is this chart—
—developed by Republican staff of the Joint Economic Committee at the direction of Rep. Kevin Brady, R-Tex., which the majority claims is inaccurate. Brady labeled the criticism, delivered in an eight-point memo, "laughable," saying the chart "depicts their health care plan as their committees developed it."
At the same time comes word from Rep. John Carter, R-Tex., that the same franking commission that is causing problems for Brady's chart won't let Carter use the words "government-run heath care plan" in a recording to be used to start a telephone town hall meeting. "What we proposed as language was as follows, 'House Democrats unveiled a government-run health care plan,'" Carter told a conservative publication. "Our response from Franking was, 'You cannot use that language. You must use, 'The House majority unveiled a public option health care plan,' which is Pelosi-speak or 'just last week the House majority unveiled a health care plan which I believe will cost taxpayers...'"
Republican staffers say this kind of censorship of the minority by the majority is almost unheard of on Capitol Hill, certainly during the years the GOP was in power. Moreover, they say, it is a clear sign that the Republicans are, for the moment, winning a fight once thought unwinnable. Rather than get them down, they are taking the efforts to suppress their message as a badge of effectiveness.
As many of you know, I'm on Facebook (and IFL has a facebook group - please befriend me, and join our group!). I've always been pleased that my Facebook page has been a sort of "town square" for public policy and political debates. I have friends who are on all points on the political spectrum, and the debates have been lively.
Many of my friends from high school are on the far left of the political spectrum. There are a host of reasons for this, you can read a lot about it on my old blog (just do a search for Fieldston, and you'll find it), and as you can imagine, many of them post from that perspective in discussions on Facebook. One of these friends is a very talented actor by the name of Ian Kahn. Ian, in responding to a "tweet" about a speech that I was giving yesterday, wrote:
"Health care for all Americans. It's the Patriotic choice."
I didn't quite understand that, so I wrote:
"And just what does that mean, Ian? Because, after all, the option being
put on the table by the Democrats and the President ISN'T "heath care"
for all Americans. It's "health insurance" for all Americans. That's
not the same thing, and, in fact, the latter could lead to the
destruction of the former."
Ian responded, "Do you have health care or health insurance? Because that line, while
it makes a great sound bite, is equivocal at best. For one of the 47
million Americans without health insurance I’m
fairly sure that would be a tough, and probably insulting distinction,
to make. The point is this... there is a proposition out there that
intends to take steps to reform our system by improving quality,
expanding coverage, lowering costs, honoring patient choice and holding
insurance companies accountable. You can agree with it. Or disagree
with it. And it may or may not succeed at achieving all its arguably
quixotic aspirations, but what is the alternative being presented? It
seems incredibly easy to stand by and take pot shots at an approach to
deal with one of the most difficult issues in recent American times,
but where are the alternative proposals? There are lives, most
literally at stake here and we are playing politics rather than coming
together to find a solution.
"Senator Jim DeMint said at a recent speech, "If we're able to stop
Obama on this, it will be his Waterloo. It will break him."
Disgraceful. American soldiers in time of war fight for all Americans.
They fight for the Americans that can’t
fight for themselves. They even fight for the Americans who disagree
with the fight itself. They fight because they believe it is in the
best interest of the Nation. Their Nation. They spill their blood for
those who are not able or not willing to spill their own. That is the
very definition of patriotism. How is that different than those of us
(myself included) who are being asked to give a little more to help
those who cannot help themselves? It is time for action. Action is what
is being offered... and if the Republicans or anybody else has a
suggestion in facing this national dilemma, I am absolutely willing and
eager and open to it."
I thought a great deal about this, and happened to read it before I was about to give my speech, so it was weighing on my mind as I spoke. This morning I wrote a response to Ian, and one of my readers wanted to share it with others. So here is my response in its entirety:
If I were one of the millions of Americans without access to health
_insurance_, Ian, what would insult me would be to find out that the
health "care" being promised to me isn't health "care" at all. Or to
find out that health care costs aren't going to go down. Or to find out
that medical care is going to become harder to find as a result of this
legislation. Or to find out that one one of a number of the promises
being made by this legislation are a mere fiction...
Fiction. As in "not true". As in "not true" because what's being
proposed is belied by the facts. The economic analyses say that costs
are going to go up, not down. History has shown us that government
intervention into health care does not increase access to it. The
current statistics are showing us that we simply do not have enough
medical care to go around.
Medical "care". As in, we do not have enough doctors, nurses, and
medical technicians to meet the demands for care that we have today.
It's Resource Economics 101 (or, probably 201): declining supply +
increased demand = increase in price.
And why do I say "declining supply"? Because more and more doctors are
leaving the medical profession each year, and we aren't backfilling
enough to meet demand - especially in those all-important primary care
specialties (family practice, internal medicine, etc).
Not only is government fiat not going to change that, it's going to
exacerbate the problem. The increase in patient "panels" (the number of
patients seen by each and every doctor), combined with the decrease in
reimbursement from the government that has to come from cost-cutting,
combined with having to deal with additional bureaucracies from
government (what is it - 87 different agencies that will be involved in
this "Rube Goldberg-like" scheme?), and you'll see the rate of medical
professional departures increase at an alarming rate.
No doctors + no nurses + no medical technicians = no health care. Insurance or no insurance.
My wife is a doctor, Ian. As it happens, she's a doctor employed by the
federal government. So the government administration of health care is
something I'm intimately familiar with.
And as for your assertion that there are no alternative proposals, you
might try doing a little research before parroting the party line on
this. From 2001 to 2009 there were a series of meaningful health-care
reform proposals that dealt with increasing access to health insurance,
increasing the supply of medical care, and bringing greater
cost-transparency and consumer choice into the marketplace. Those
alternatives continue to be on the table, such as:
- Association Health Plans: These would have allowed small
businesses (which comprise 90+ of all employers and provide 2/3 of all
new jobs) to band together across state lines in order to create risk
pools for the purposes of buying insurance. This would have driven down
the cost of employer-provided insurance plans and allowed for greater
numbers of small businesses to provide health insurance to their
How did it fare? Defeated by the Democrats at the behest of their
special interest donors, the AARP and the Service Employees
- Tort Reform: A key component of what's driving doctors out of
the medical field is the cost of doing business, especially the cost of
malpractice insurance. Reforming the penalties that can be levied in
malpractice cases would drive those premiums down (which can amount to
thousands PER MONTH), and keep Doctors in business.
How did it fare? Defeated by the Democrats at the behest of their
special interest donor, the American Trial Lawyers Association.
- Medical Savings Accounts: An alternative to high-cost health
insurance is the Medical Savings Account or Health Savings Account, a
tax-free option which allows people to pay for their primary care
directly, creating cost transparency and true competition in the
marketplace. Because doctors who take MSAs aren't doing complicated
insurance or government billing, it eliminates tremendous amounts of
expensive paperwork, thus further driving down costs.
How did it fare? Watered down by the Democrats at the behest of a variety of their special interest donors.
There were other options: tax credits for the costs of health insurance
for small business (as opposed to what they want to do now: jack up
costs and penalize businesses that can't afford them); finding ways to
decrease the costs of medical school, increasing service opportunities
to pare down medical school debt, etc.
These have all been defeated, one way or another, by those who want to
force everyone into a one-size fits all approach to medical care.
I'm not being "asked" to give a little more, Ian. I'm being forced.
There's a tremendous difference. Volunteerism, especially voluntary
giving to charity, is a high moral aspiration. State coercion is the
Every increased dollar that the government takes from me is one less
dollar that I can give to charities. Charities who can provide that
medical care (again, NOT insurance) to those who cannot otherwise
afford comprehensive insurance.
I found it galling when Sen. Ben Cardin on Monday chastised a young man
who didn't want to be penalized for making the choice to not have
health insurance. He didn't deny that the man would be penalized (to
the tune of $200+ per month, money he may not otherwise have), he
essentially said, "How dare you!"
That's disgraceful, Ian. An elected official hectoring a constituent
for exercising his free will is disgraceful. An elected official
laughing when asked if he would pledge to read a thousand-plus piece of
transformational legislation is disgraceful. Hoodwinking the American
public into believing that this piece of legislation will solve their
health care woes is disgraceful.
And that last point isn't working. I'm not going to call this the
President's Waterloo - and about that, Waterloo wasn't Wellington's
personal "beef" with Napoleon (no pun intended). Waterloo was about
putting a stop to the spread of French imperialism.
But the bottom line is that this isn't what Americans voted for in
November (and not what they voted for in 2006, either)--which is why an
ever-increasing number of them are opposing this plan.
For the U.S. News Thomas Jefferson Street blog
Back in the days when the Republicans controlled the U.S. House of Representatives, the Democrats repeatedly accused them of abusing the power of the majority to further their agenda. In one particularly onerous charge, repeated for days in the media, they accused the GOP of trying to "buy" the support of then-Rep. Nick Smith, R-Mich., for President Bush's signature Prescription Drug Reform package with the promise of campaign contributions for his son, who Smith hoped would succeed him in Congress.
To show how seriously the Democrats took the issue, then-House Minority Leader Nancy Pelosi, D-Calif., stood in the well of the House in December of 2005 to offer a privileged resolution which, in part, accused the Republicans of "bullying and threatening Members to vote against their conscience."
Pelosi's resolution, which also accused the Republicans of "violat(ing) their own rules and the customs and decorum of the House to win votes," called on then-Speaker Dennis Hastert, R-Ill., to take whatever actions might be necessary to prevent further abuse of the House rules.
But that was a long time ago. Things are different now that Pelosi is Speaker and the Democrats have a comfortable majority—or are they?
On Friday Politico's Mike Thrush reported on what the publication called a "Big Dem cash dump on eve of climate vote." Thrush wrote that, "Three House Democratic leaders who were whipping members on the climate change bill gave tens of thousands in campaign cash to party moderates around the time of the 219-212 vote on June 26, according to Federal Election Commission records."
And one of those leaders doling out money was, don't get ahead of me, Speaker Nancy Pelosi.
Thrush does allow that not all those Democrats who got money voted to pass the Waxman-Markey legislation but the timing of the contributions is suspicious.
Rep. Henry Waxman, D-Calif., who co-authored the bill, and who gave at least $16,000 in contributions to members who voted "Yes" on his bill, said through a spokesman that the contributions were nothing more than the usual "end-of-quarter activity." Which sounds a lot like the kind of thing the Republicans might have said when they were in the majority.
An exchange between Wisconsin Democrat Herb Kohl and Sonia Sotomayor during her first day of testimony before the Senate Judiciary Committee made me think of Animal House. Kohl, who before becoming a constitutional scholar was the owner of a professional basketball team, quizzed Sotomayor on her views about privacy as relates to the U.S. Constitution. "As you know Judge," he asked Sotomayor, "the landmark case of Griswold v. Connecticut guarantees that there is a fundamental constitutional right to privacy as it applies to contraception. Do you agree with that? In your opinion, is that settled law?"
"That is the precedent of the court, so it is settled law," she said.
The nomination of Sonia Sotomayor has brought all manner of reaction from across the political spectrum, positive and negative, liberal and conservative. The comment was raised on my Facebook page that Sotomayor was "inspiring and refreshing", to which someone responded, "Inspiring and refreshing is for the newest "fashiontini" not a Supreme Court Justice."
I'm not a lawyer, but between the ages of 16 and 28 I worked for and with lawyers, and for 4 years was the reader to a blind environmental lawyer. One of his areas of expertise was private property rights, and I developed a real passion for the subject.
I have continued to be dismayed with what Justice Scalia termed as the "relegation of property rights to the status of a poor relation". We were warned about Justice Roberts' view of the mutability of private property rights, even coming on the heels of the Kelo decision, and our concerns were justified when Roberts paved the way for further erosion of property rights in the Jones v. Flower decision (I wrote on that here: http://langrrr.blogspot.com/2006_05_01_archive.html ).
And now we have Judge Sotomayor, who, apparently, could be even worse. The noted law professor, Richard Epstein, has this to say in a piece at Forbes (http://www.forbes.com/2009/05/26/supreme-court-nomination-obama-opinions-columnists-sonia-sotomayor_print.html ):
"Here is one straw in the wind that does not bode well for a Sotomayor appointment. Justice Stevens of the current court came in for a fair share of criticism (all justified in my view) for his expansive reading in Kelo v. City of New London (2005) of the "public use language." Of course, the takings clause of the Fifth Amendment is as complex as it is short: "Nor shall private property be taken for public use, without just compensation." But he was surely done one better in the Summary Order in Didden v. Village of Port Chester issued by the Second Circuit in 2006. Judge Sotomayor was on the panel that issued the unsigned opinion--one that makes Justice Stevens look like a paradigmatic defender of strong property rights.
"I have written about Didden in Forbes. The case involved about as naked an abuse of government power as could be imagined. Bart Didden came up with an idea to build a pharmacy on land he owned in a redevelopment district in Port Chester over which the town of Port Chester had given Greg Wasser control. Wasser told Didden that he would approve the project only if Didden paid him $800,000 or gave him a partnership interest. The "or else" was that the land would be promptly condemned by the village, and Wasser would put up a pharmacy himself. Just that came to pass. But the Second Circuit panel on which Sotomayor sat did not raise an eyebrow. Its entire analysis reads as follows: "We agree with the district court that [Wasser's] voluntary attempt to resolve appellants' demands was neither an unconstitutional exaction in the form of extortion nor an equal protection violation."
"Maybe I am missing something, but American business should shudder in its boots if Judge Sotomayor takes this attitude to the Supreme Court. Justice Stevens wrote that the public deliberations over a comprehensive land use plan is what saved the condemnation of Ms. Kelo's home from constitutional attack. Just that element was missing in the Village of Port Chester fiasco. Indeed, the threats that Wasser made look all too much like the "or else" diplomacy of the Obama administration in business matters.
"Jurisprudentially, moreover, the sorry Didden episode reveals an important lesson about constitutional law. It is always possible to top one bad decision (Kelo) with another (Didden). This does not augur well for a Sotomayor appointment to the Supreme Court. The president should have done better, and the Senate, Democrats and Republicans alike, should subject this dubious nomination to the intense scrutiny that it deserves."
Over the weekend the McClatchy news chain reported that supporters of Supreme Court nominee Sonia Sotomayor were urging members of the Senate Judiciary Committee to attack "troubled and litigious work history" of firefighter Frank Ricci, the lead plantiff in the workplace discrimination case upon which, in essence, Judge Sotomayor recently ruled - and on which she was overturned by the United States Supreme Court.
To be clear -- attacking first responders in an effort to burnish the credentials of a presidential nominee for any office is a bad strategy.