Before everyone forgets all about it (which could happen any day now), here are my thoughts on Barack Obama and the Democrats' legislative victory this week. As followers of this page know, I'm on record supporting the bill that is now the law of the United States, on the rudimentary grounds that it is intolerable in 21st century America, that access to the health coverage I take for granted be denied to individuals on the sole basis that they actually require health care. Every other factor in the debate, for me, is subject to that moral imperative, including economic costs and political realities. Put another way, if the government is going to spend itself into oblivion, I'd at least prefer it spend on this.
However. To my friends on the left, let there be no doubt that true progressives got rogered here but good, in two ways. First, the liberal wing in Congress proved yet again that they'll never actually abandon the Democratic party agenda when the chips are down; not in the way the far right will ultimately hang the Republicans out to dry. Second, as Greenwald articulates the way no one else can, this bill represents a massive expansion of the same private insurance industry whose worst practices it purports to correct. Nothing that would have reined in the free-market-gaming at the heart of this matter and truly lowered prices over the long term (e.g. interstate competition, bulk price negotiation, re-importation, and most especially, a public option) was ever truly on the table, because Barack Obama didn't think he could get this done if he had to fight with the insurance companies and the Republicans at the same time. And so the price for near universal coverage is an individual insurance mandate, which, while probably economically and Constitutionally sound, is nevertheless offensive to personal liberty. We could have done better, and this victory represents a continuation of a lousy precedent that keeps the public sphere beholden to cloistered corporate interest.
Second, also to my friends on the left, let no one doubt that the estimated costs of this program are likely way, way lower than reality, absent a high level of vigilance over the long term. My friend Paul lays out some examples on his blog of analogous government projections which turned out to be short - there's no reason to think this is going to be any different. The CBO score that came out Friday got the Democrats over the top - but that was political cover, not true economic reality. The reform is gonna need some reform, and it will be required long after Barack Obama leaves office. This is our responsibility now.
Third - to my friends on the right, I don't begrudge you the differences in philosophy or economic projections. What I do feel compelled to challenge, what I feel is somewhat unworthy of you, is the constant accusation that in enacting this reform, the Democrats have ignored the will of the American people, betrayed their oaths of public service, or, less prosaically, rammed this sucker down our throats. To wit, a couple of links. First, a recent CNN poll, from before the vote, that shows 52% of the American people either supporting the bill or opposing it because it isn't liberal enough. Not passing anything would not have pleased anyone in that group, so it was the will of the American people all along that something be done rather than nothing. Second, an overnight Gallup poll from immediately after the bill passage that shows an almost immediate increase in support the Democrats' achievement - it polls at an even split now, after only one day, which indicates that support is on the rise in the same way that Barack Obama's approval ratings after his election exceeded the percentage of votes that he got. And finally, a poll from FiveThirtyEight showing the high favorability ratings for all the individual components of the bill, even while approval for the full bill lagged behind, indicating more dissatisfaction with the legislative process than with the substance. None of this is to say that public opinion won't continue to shift, or that those in opposition to reform are wrong on the merits - only that sustaining an accusation that the Democrats are subverting the "will of the people" is like nailing jello to a wall. It doesn't stick, and we would all be wise to simply ignore the Republicans saying otherwise. The plain fact of the matter is that Barack Obama won an election the same way Scott Brown did, and so did 219 House Democrats and 59 Senate Democrats (from states representing over 70% of the people, by the way), and a lot of them were elected to do stuff just like this. That was the will of the American people. I have no idea what's going to happen this November or in 2012, mind you - and neither does anyone else - but my humble guess is that it will have a lot more to do with the candidates themselves and the economy than with this health care bill.
And about all those projections of doom and gloom, creeping socialism, tyranny, and the loss of the American soul. The skyrocketing premiums, the loss of personal wealth, the insurmountable government debt, the stalled innovation, the dearth of doctors - all those possibilities are empirically testable, through careful and honest analysis, now that this bill has become law. Better than that, if they do start to occur, there are legislative remedies for all of them, and elections every two years that can make a difference. We aren't done here, and we haven't just started - we're in the middle of a long, circuitous process that doesn't live or die with one bill. Keep at entitlement reform, keep tearing down barriers to competition, keep fighting - above all, go win elections by espousing good policy for Pete's sake, and keep in mind that being the opposition isn't the same thing as being the enemy.
Because here's what I love about all this: hidden deep within all the screaming matches, the mathematical acrobatics, the obfuscations, the anecdotes and the generalizations, is a real honest-to-God conversation about what kind of country we are, and what our contract with one another really means. What is the central political challenge of Western democracy? Is it ensuring that those who come by their wealth honestly don't have it unfairly confiscated and redistributed? Or is it promoting the general welfare, setting the conditions that provide the most opportunity and do the most good for the most people? Both of these are moral imperatives in public life, and neither the proponents of one nor of the other can claim to be the only ones on the side of angels. The left too often indulges an overconfidence about what can be achieved by government, and too easily glosses over unintended consequences. The right, by the same token, often fails to recognize that there are other threats to liberty in modern life besides government, and that government at its best can be an affirmative check against those forces. What we as a people strive for is balance, and balance, if it comes at all, comes only by way of argument and the democratic process. In summary, political wisdom chooses its companions very selectively, and among these are Temperance, Humility, Generosity, Compassion, and if one is so inclined, faith in and hope for this great country.
God bless America.
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