Posted by Alan on November 9, 2009
Democrats paid a heavy toll to keep health care reform moving forward. They were forced to accept substantial and virtually unprecedented limits on abortion coverage in order to get the Affordable Health Care for America Act through the House of Representatives. This result should awaken them to the need to rethink their approach, but it assumes they learned the key lesson: where government goes, ideology follows.
Speaker Nancy Pelosi needed 218 votes to make history: passage by the House of the Affordable Health Care for America Act. Liberals got her most of the way there, but to get across the finish line Speaker Pelosi needed support from moderates and conservatives. This meant cutting a deal with the pro-life caucus. The result: HR 3962 prohibits the government-run medical plan and coverage offered through the health insurance exchanges the bill would create from covering elective abortion procedures. Liberals are furious, but to pass health care reform they had to accept this restriction as part of the package.
This post is not about the politics or morality of abortions. Readers of this blog are on both sides of this issue. This blog is about health care reform and what happened to HR 3962 concerning abortion highlights one of the greatest pitfalls in Democrats approach to reform. If they continue down the road they are on, increasing the amount of America’s health care system government directly controls and manages, the party is guaranteeing that similar defeats on similar public policy issues is all but a certainty. The issue today is abortion. In the future it could be access to birth control. Or making coverage available to domestic partners. The fact is, government-run health care does not and cannot exist in a vacuum. Politics and ideology inevitably come along for the ride.
The final health care reform bill may loosen the prohibition on abortion coverage contained in the House bill. But if the restrictions are diminished, it will be because Democrats led by Speaker Pelosi and Senate Majority Leader Harry Reid are in control of Congress and President Barack Obama occupies the Oval Office.
Eventually conservatives will be in power again. No party or ideology dominates America’s politics forever. And a conservative government will not hesitate to use the tools given to it by Democrats to push forward their agenda merely because those tools were created by liberals.
No one should be surprised about this political reality. In a post back in August 2007 I warned single payer advocates that a government takeover of health insurance would open the door to ideology meddling by conservatives. And in August of this year I reminded liberals that while Democrats are ascendant today, politics, like a pendulum, eventually changes direction. “In 2001 the President was George W. Bush, the Senate Majority Leader was Trent Lott and the House Speaker was Dennis Hastert (just two years earlier it had been Newt Gingrich). Their view of how a public health plan should work – what it covers and who it benefits – varies considerably from the Obama/Reid/Pelosi view. Yet the greater the role liberals give the government over health care, the more control over issues like abortion conservatives like Bush/Lott/Hastert will have when they take power again – and eventually, they will.” And I’m hardly the only observer to state this reality.
So Democrats face a critical choice. They can pursue their health care reform goals care by increasing government’s direct participation in the market or by looking to the regulations the government imposes on the market. One opens the door wide to groups of lawmakers holding health care reform hostage to unrelated public policy issues; the other narrows this opening.
For example, lawmakers want to prohibit carriers from denying consumers coverage because of their current or previous health conditions. Creating a health insurance exchange is one method of achieving this goal, but it is not the only way. And alternatives limit the opportunity for ideological meddling in Americans’ lives.
Yes, a public plan would increase competition in the market (a primary justification for a government-run plan), but so would health insurance co-operatives. And as non-government entities, co-operatives would be less susceptible to partisan interference.
By focusing on their goals and being careful of their methodology for achieving them, Democrats can have their health care reform and limit the price they’ll pay on other issues. Or they can continue down a road in which accepting limits on abortion coverage is merely the first of many heavy and painful tolls they will pay.
Posted in Barack Obama, Health Care Reform, Healthcare Reform, Politics, Single Payer | Tagged: abortion, Affordable Health Care for America Act, Dennis Hastert, George Bush, government health plan, Harry Reid, health insurance cooperatives, health insurance exchange, HR 3962, Nancy Pelosi, Newt Gingrich, public health insurance plan, Trent Lott | 5 Comments »
Posted by Alan on August 10, 2009
Health care is personal, important, confusing and expensive. No wonder so many people are upset at attempts to reform America’s health care system. The status quo may be broken, but the devil known is more welcome than the devil coming to town.
It’s especially scary for conservatives who look at the folks doing the reforming and are terrified. When they see President Barack Obama, Senate Majority Leader Harry Reid and House Speaker Nancy Pelosi they see liberals – actually they see LIBERALS. The kind their parents warned about. These aren’t fellow Americans with whom they happen to disagree, they’re “the others,” the socialists, the government building, boogie men of talk radio and a certain 24 hour news station. (And yes, this being America, there’s a 24 hour news station boosting fear of conservative boogie men, too).
It takes a giant leap to think that elected leaders in America are plotting to create a system with death panels that will impose euthanasia on seniors, make virtually every health care decision in the country, murder millions of children and much more. Yet those are the accusations made by former Governor Sarah Palin, Cal Thomas, Representative Virginia Foxx, and Representative John Shadegg. And many on the right take are predisposed to take these accusations seriously.
Then there are more legitimate controversies that health care reform impacts. For example, should health plans health plans be required to cover abortions? That’s a legitimate public policy issue although it’s often weighed down by political rhetoric that obscures the real issues.
All of this makes it easy for liberals to dismiss these concerns. They see the need for a public health insurance plan to increase competition, not drive private carriers out of business. Evaluating the cost and effectiveness of care makes common sense and sound economics. It has nothing to do with being intrusive. There’s nothing sinister about this approach, but conservatives view such claims with fear and loathing.
What we have here are two groups of people looking into the same room from different windows. What they see is colored by where they stand and the prejudices they bring to the view. Where one sees conspiracy and death panels the other sees common sense and prudent regulation.
This is more than just a fascinating glimpse into the human psyche and how it plays out in the public policy arena. It underscores the challenge facing those seeking change. They need to not just fashion a workable system, but they have to deal with the fears and suspicions of those who instinctively oppose them – fears and suspicions that are stoked for self-aggrandizement and profit by the Glenn Becks and Michael Moores of the world.
Then there’s the political element of this dynamic. Liberals can comfortably ignore the concerns of conservatives regarding health care reform. All they need to do is bring enough moderates along to build the majorities needed to pass their legislation.
But in American politics the pendulum swings. In 2001 the President was George W. Bush, the Senate Majority Leader was Trent Lott and the House Speaker was Dennis Hastert (just two years earlier it had been Newt Gingrich). Their view of how a public health plan should work – what it covers and who it benefits – varies considerably from the Obama/Reid/Pelosi view. Yet the greater the role liberals give the government over health care, the more control over issues like abortion conservatives like Bush/Lott/Hastert will have when they take power again – and eventually, they will.
Fear and suspicion, anger and foolishness knows no ideology. The left and right are equally susceptible to assuming and perceiving the worst in the actions and words of the other side. Both have paid cheerleaders to make stoke their worst predilections.
As lawmakers consider the impact of health care reform they should keep in mind the American political wheel turns. Eventually all of us watch our elected leaders with fear and loathing. And the greater the influence government has on health care the more vitriolic the suspicion, anger – and the danger.
Posted in Health Care Reform, Healthcare Reform, Politics | Tagged: abortion, Cal Thomas, Dennis Hastert, euthanasia, George Bush, Glenn Beck, Harry Reid, John Shadegg, Michael Moore, Nancy Pelosi, Newt Gingrich, Sarah Palin, Trent Lott, Virginia Foxx | 21 Comments »