Commentary: Flaws in the health care overhaul plan

The Kansas City StarNovember 18, 2009 

This may sound surprising, but Republicans don't have a monopoly on opposition to health care reform. Some Democrats also have doubts — if not on the merits of the plans before Congress, then on the decision to put health care ahead of reviving the economy. Here's what three have to say.

Start with Robert Reich, labor secretary during the Clinton administration. As Reich wrote recently on his blog, he supports "genuine health reform." But he questions Obama's priorities.

"While affordable health care is critically important to Americans, making a living is more urgent. Yet the administration's efforts to date on this more basic concern have been neither particularly visible nor coherent. …

"If Obama and the Democrats lose one or both houses of Congress in the midterms, it will be because the president learned only the most superficial lesson of the Clinton years. Health-care reform is critically important. But when one out of six Americans is unemployed or underemployed, getting the nation back to work is more so."

Indeed. Then there's Camille Paglia, the always-volatile loose cannon of the left, who takes it up several notches at Salon.com. She praises House Speaker Nancy Pelosi for being ruthless in pushing through the bill, but Paglia turns on a dime and blasts the bill as "rigid, intrusive and grotesquely expensive…

"Why can't my fellow Democrats see that the creation of another huge, inefficient federal bureaucracy would slow and disrupt the delivery of basic health care and subject us all to a labyrinthine mass of incompetent, unaccountable petty dictators?"

She doesn't understand the bill's failure to allow consumers to buy insurance across state lines, which would boost competition and hold down prices. Paglia asks: "What covert business interests is the Democratic leadership protecting by stopping consumers from shopping for policies nationwide?"

But the real topper in this group is John Cassidy, whose recent New Yorker piece, highlighted in a Wall Street Journal editorial, gives the Democrats' game away. Actually, I don't know if he's a Democrat, but he certainly supports the Dems' health care reform. He calls it "ethically essential, economically justified and long overdue."

But he admits it won't save money, which was supposed to be one of the main points. Cassidy may be a supporter, but his piece often reads like an indictment:

•The Obama administration has promised cost savings. But Cassidy concludes they're based on "wishful thinking and sleight of hand. Over time, the reform, as proposed, would almost certainly add substantially to the budget deficit, thereby worsening the long-term fiscal crisis that the country faces."

•The bill recently passed by the House fails to deal with the basic cause of rising health care costs, "much of which is rooted in the nature of insurance, where individuals consume costly services, and different people — the other members of the risk pool — pay for them."

•Don't believe the predictions that health care reform will be self-financing. Cassidy writes that, "What is really unfolding … is the scenario that many conservatives feared. The Obama administration … is creating a new entitlement program, which, once established, will be virtually impossible to rescind."

Nor is this effort solely about health care, or a bid to make the United States a "more equitable society." Cassidy says this is all part of the Democrats' "political calculus" — meaning, I assume, that if voters are more dependent on government, they will tend to support the party of government, namely the Democrats.

Cassidy believes that "expanding health care coverage now and worrying later about its long-term consequences is an eminently defensible strategy." It will make American society more "equitable," and perhaps justifies a little "subterfuge" with the numbers.

Cassidy should be saluted for his honesty. But judging by the polls, many voters wouldn't call this kind of deception a "defensible strategy."

What the Democrats have in mind will transform the historic relationship between American citizens and their government. I doubt most voters would agree that something this sweeping should be passed using "subterfuge," coupled with a mad rush to ram it through now and worry later about the consequences.

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