Commentary Magazine


Health-Care Larceny

In a perfectly crafted paragraph, Michael Gerson sums up where we are on health-care “reform” (more about that later):

The most visible Democratic domestic priority of the past 40 years must be smuggled into law, lest too many Americans notice. Politicians claiming the idealism of saints have adopted the tactics of burglars. Victory, if it comes, will seem less like a parade than a heist.

Why the need for the lawlessness? Because the president has failed to persuade the country of its merits, and he and Nancy Pelosi have their hands full trying to wrestle the final House Democrats to the mat.

The bill is in no meaningful sense “reform,” which was the premise of the entire undertaking. For example, it was going to slow the increase in premiums. But even the AP acknowledges, “Premiums are likely to keep going up even if the health care bill passes, experts say. If cost controls work as advertised, annual increases would level off with time. But don’t look for a rollback. Instead, the main reason premiums would be more affordable is that new government tax credits would help cover the cost for millions of people.” Hmm. This was precisely the point Sen. Lamar Alexander and Rep. Paul Ryan made at the health-care summit.

And what about budget neutrality or entitlement “reform”? Gerson says that’s not happening:

The problem here is not only accounting tricks and the assumption of unprecedented courage on the part of future Congresses when it comes to Medicare cuts — though these are bad enough. The main source of irresponsibility is that the revenue-gaining measures in the health bill — particularly Medicare cuts and taxing “Cadillac” health plans — would be used to create a new entitlement instead of repairing an existing one. …

The unfunded liability of America’s current entitlements is more than $100 trillion. Medicare will eventually require a massive infusion of cash under a congressional entitlement fix. Both the Congressional Budget Office and the Medicare actuary have pressed the point that Medicare savings can be used to pay future Medicare benefits or to finance new spending outside Medicare — not both. When the entitlement crisis arrives, Obama will have already spent much of the resources required to meet it, leaving growth-killing new taxes as the main remaining option.

So you can see why we’re down to parliamentary larceny. It’s probably what we should have expected from a bunch of Chicago pols. But it’s certainly not very hope-n-changey. It’s probably not even constitutional.

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