I was distressed to read this post by Megan McArdle about “The Future after Health Care,” particularly this part:
If the GOP takes the legislative innovations of the Democrats and decides to use them, please don’t complain that it’s not fair. Someone could get seriously hurt, laughing that hard.
But I hope they don’t. What I hope is that the Democrats take a beating at the ballot boxand rethink their contempt for those mouth-breathing illiterates in the electorate. I hope Obama gets his wish to be a one-term president who passed health care. Not because I think I will like his opponent–I very much doubt that I will support much of anything Obama’s opponent says. But because politicians shouldn’t feel that the best route to electoral success is to lie to the voters, and then ignore them.
There seem to be three complaints here. The first is that the American people don’t want health care reform, or at least this version of health care reform. I don’t think anyone will hold up the bill that will pass as exemplary, but it does reflect elements of health care reform that Democrats campaigned on and won on in 2008. So I have a hard time seeing this as doing violence to the will of the people as it is typically expressed in our electoral system. Elections matter. This is how they matter.
The second complaint is that the Democrats have done violence to the legislative process to get the bill passed. I am not a fan of these crazy parliamentary tricks, but just rewind the clock, as Bruce Bartlett does so well, to the 2003 legislative process on Medicare Part D. The Republicans had both houses of Congress and the White House but had trouble getting the bill passed. Again, I am going to need to be convinced that what happened in March 2010 is a more hideous affront to standards of legislative conduct than what happened in November 2003. This is not excusing the current process — it is calling BS on claims that the Democrats have somehow stooped to a new low. Sadly, they have not.
The third complaint is the most legitimate of the three, that we have created a new entitlement with dubious financing and greater government involvement in the provision of health care. This is more true than I would like it to be, but given what Republicans passed with Medicare Part D, they have surrendered the fiscally responsible high ground. And, more importantly, they surrendered the political high ground when they failed to propose a coherent alternative that addressed the critical problems of pre-existing conditions in health insurance markets. It was a mystery to me that no Republican stepped up with a sensible alternative that addressed the structural problems without committing to such a large federal government role in the conduct and financing of health care markets. That was the fight they should have had. To say that they lost would not be right. They simply didn’t show up.