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A Modest Proposal for Health Care

At the Huffington Post, Sam Stein reports on the Netroots Nation keynote speech last night by Bill Clinton, given to a “crowd of bloggers, online activists, and a slew of Democratic lawmakers,” seeking to have them make one last major push to pass health-care reform. Stein quotes Clinton as saying:

I’m telling you no matter how low [Republicans] drive support for this with misinformation, the minute the president signs a health care reform bill his approval will go up. Secondly, within a year, when all those bad things they say will happen don’t happen, and all the good things happen, approval will explode.

I have a different prediction. Within a year after the bill is passed, a lot of the first-term members of Congress who vote for it will be back in the private sector, hoping to find jobs with employers who won’t dump their insurance into the public “option.” What will explode will be something other than the members’ approval ratings—it will be something closer to what happened the last time Bill Clinton sang this siren song.

According to Stein, Clinton urged Democrats not to “lose their nerve.” “I’m pleading with you,” he said, “try to keep this thing in the lane of getting something done. We need to pass a bill.” The slew of Democratic lawmakers may have made a mental note that they—not “we”—are the ones who will be on the ballot next year.

Clinton referred to “a” bill—not “the” bill: right now there is no one bill, just a bunch of bills floating around. At least with cap-and-trade, there was a single bill—Waxman-Markey—even though the version to be voted on wasn’t available to be read until sometime about 3 a.m. the day before it passed.

Here is a modest proposal for those who wish to remain in Washington for the 111th Congress that convenes in January 2011: Cobble together a tentative majority for a specific bill—and then don’t pass it; instead, schedule hearings on it; put it out in written form, with a plain English explanation, so the public can read and comment on it; let experts testify in public about it; and only then put it to a vote. And hold a hearing at the same time on the Republican alternative.

Right now, the public is faced with an administration and a Congress insulting its intelligence. The president seeks to frame the debate as one between those who “want to do nothing” and those who will back his supposedly deficit-neutral, cost-saving, quality-preserving, long-overdue panacea that will cover everyone lacking insurance while changing nothing for those satisfied with what they have. He urges us to support whatever it is that will emerge from the backroom deals still in the process of being cut but that needs to pass right now, preferably a couple of weeks ago.

The debate is better described as one between those who want a wholesale revision of one-seventh of the economy, to be managed from Washington by those currently in charge of the post office, and those who want to enact reforms that will empower millions more individuals to purchase insurance from private companies through legal and tort reform, tax credits, and similar changes. But if the debate remains in its current caricatured form of a choice between (a) pie-in-the-sky and (b) doing nothing, the public will choose the Hippocratic pledge of first doing no harm.

And those who doubt that real harm is possible should read Tevi Troy’s compelling analysis in “The End of Medical Miracles?” in the June issue of COMMENTARY.


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