Commentary Magazine


Topic: government utilities

The Substance Matters, or It Should

Politico reels off five impediments to passage of ObamaCare (e.g., reconciliation, abortion, Senate-House mistrust) but doesn’t get around to the two biggest problems: it’s a bad, irresponsible bill and the voters hate it. Oh yes, that. This bit of misdirection pleases Democratic leaders, who would like the discussion to be about anything but the substance of what members are being asked to vote on.

Rep. Paul Ryan, however, isn’t playing along. He takes to the Washington Post to explain precisely what’s wrong with the bill:

Through any analytical lens, the legislation will not address the central problem of skyrocketing health-care costs. The Congressional Budget Office estimates that families’ premiums could rise 10 to 13 percent; private-sector actuarial estimates top these already high numbers. The higher costs are driven by federalizing the regulation of insurance, narrowing consumers’ options and reducing competition among providers. The health-care market would be dominated by government programs and the largest insurance companies, operating as de facto government utilities.

Rather than tackle the drivers of health inflation, the legislation chases the ever-increasing premiums with huge new subsidies. Already, Washington has no idea how to pay for the unfunded promises in Medicare, Medicaid and Social Security — and creating this new entitlement would accelerate our path to fiscal ruin. When you strip away the double-counting, expose the hidden costs that must be funded and look at the price tag when the legislation is fully implemented, the claims of deficit reduction are as hollow as claims of cost containment.

In short, the cost-containment problem (otherwise we’ll bankrupt ourselves, the president once threatened) is made worse, dramatically so, by the bill. And when we add on “a range of job-killing tax hikes and controls on all Americans,” you have a truly destructive, ill-conceived piece of legislation. If members think hard about that, rather than the arm-twisting and bravado from the White House, what the leadership is up to will become apparent. They are not, it seems, in the business of passing anything remotely resembling “reform.” They are rather attempting to avoid humiliation and prevent a tidal wave of rage from their liberal base.

That’s small consolation to moderate Democrats, who, in their quieter moments of self-reflection, understand not only that their constituents intensely dislike the bill but also that such aversion is fully justified. It would be one thing to challenge public opinion for a noble and necessary bill; it’s quite another to walk the plank for what Ryan dubs “the Democrats’ health-care train wreck.” All the tricks — reconciliation, voting but not really voting on the Senate bill — are designed to encourage lawmakers to do something many know isn’t wise substantively or politically. If Republicans are smart, they’ll spend the week forcing Democrats to look at their handiwork and reminding them that voters will hold them fully accountable for their mischief.

Politico reels off five impediments to passage of ObamaCare (e.g., reconciliation, abortion, Senate-House mistrust) but doesn’t get around to the two biggest problems: it’s a bad, irresponsible bill and the voters hate it. Oh yes, that. This bit of misdirection pleases Democratic leaders, who would like the discussion to be about anything but the substance of what members are being asked to vote on.

Rep. Paul Ryan, however, isn’t playing along. He takes to the Washington Post to explain precisely what’s wrong with the bill:

Through any analytical lens, the legislation will not address the central problem of skyrocketing health-care costs. The Congressional Budget Office estimates that families’ premiums could rise 10 to 13 percent; private-sector actuarial estimates top these already high numbers. The higher costs are driven by federalizing the regulation of insurance, narrowing consumers’ options and reducing competition among providers. The health-care market would be dominated by government programs and the largest insurance companies, operating as de facto government utilities.

Rather than tackle the drivers of health inflation, the legislation chases the ever-increasing premiums with huge new subsidies. Already, Washington has no idea how to pay for the unfunded promises in Medicare, Medicaid and Social Security — and creating this new entitlement would accelerate our path to fiscal ruin. When you strip away the double-counting, expose the hidden costs that must be funded and look at the price tag when the legislation is fully implemented, the claims of deficit reduction are as hollow as claims of cost containment.

In short, the cost-containment problem (otherwise we’ll bankrupt ourselves, the president once threatened) is made worse, dramatically so, by the bill. And when we add on “a range of job-killing tax hikes and controls on all Americans,” you have a truly destructive, ill-conceived piece of legislation. If members think hard about that, rather than the arm-twisting and bravado from the White House, what the leadership is up to will become apparent. They are not, it seems, in the business of passing anything remotely resembling “reform.” They are rather attempting to avoid humiliation and prevent a tidal wave of rage from their liberal base.

That’s small consolation to moderate Democrats, who, in their quieter moments of self-reflection, understand not only that their constituents intensely dislike the bill but also that such aversion is fully justified. It would be one thing to challenge public opinion for a noble and necessary bill; it’s quite another to walk the plank for what Ryan dubs “the Democrats’ health-care train wreck.” All the tricks — reconciliation, voting but not really voting on the Senate bill — are designed to encourage lawmakers to do something many know isn’t wise substantively or politically. If Republicans are smart, they’ll spend the week forcing Democrats to look at their handiwork and reminding them that voters will hold them fully accountable for their mischief.

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