The latest phase of the health-care debate exposes more vividly than ever the perversity of the current federal system. President Obama came into office on a wave of hope and promise of change. Every 20 or 30 years since the end of the long slumber of post–Civil War, non-interventionist presidents (the eight between Lincoln and TR), someone has bustled into office seeking radical change.
Theodore Roosevelt owed his accession (in 1901) to President McKinley’s assassin and to incompetent medical care in Buffalo (Canadians didn’t stream there in large numbers in those days for better health care). So he moved gradually to promote conservation, truth in packaging, tighter quality standards in food and drugs, and reduction of the power of corporate monopolies. Woodrow Wilson owed his election (1912) to the Republican split between Taft and Roosevelt, yet he produced tariff reform and the Clayton Antitrust Act, and founded the Federal Reserve to take currency and banking regulations away from the commercial banks.
From the depths of the Great Depression, Franklin D. Roosevelt (1932) promised and delivered the New Deal, to mixed but generally favorable historic reviews (despite the current revisionist nonsense that he prolonged the Depression) and overwhelming popular support in four straight presidential elections and seven consecutive congressional-election victories.
John F. Kennedy (1960) promised a New Frontier and was apparently energetic and activist, as well as attractive and witty, compared with his septuagenarian predecessor, Dwight D. Eisenhower — who had persuaded the country that he was a seamless combination of the kindly avuncular golfer with the victorious, five-star military-theater supreme commander. In fact, Kennedy’s health was poor, and his judgment was not always much better. He blundered into the Bay of Pigs, which the ex-general Eisenhower had declined to approve, and was bullied in Vienna by Soviet leader Khrushchev, whom Eisenhower — as a wartime comrade of Stalin and Zhukov — had rather intimidated.
Lyndon Johnson, the antithesis of a new face and agent of change, the incarnation of congressional log-rolling and machine politics, passed Kennedy’s program, but — apart from civil rights — most of it didn’t work very well. And Ronald Reagan (1980) cut and simplified taxes and delivered the change he promised and was politically rewarded.
Barack Obama’s signature initiatives were health-care reform and taxing and reducing carbon emissions. He claimed he wanted to insure the medically uninsured, but set out to take over the insurance of those already insured. He said he was doing so to reduce costs, but no one believes that nationalization would achieve that. He claims his plan will not increase the deficit, but to the extent that that objective is achieved, it will be by stripping Medicare and crowding millions of people into Medicaid, which will bankrupt many of the states while providing very inferior care.
The whole global-warming argument has collapsed. The world is not warming and carbon emissions don’t have any detectable impact on the world’s temperature, and the authors of the fiction are fleeing like the scoundrels in Mark Twain’s Royal Nonesuch. (“To be or not to be, that is the bare bodkin,” etc.) Yet just ten weeks ago, the president was padding around Copenhagen — the looniest, most futile, seriously attended international conference in history — asking for the commitment of $100 billion a year for the Mugabes and Chávezes (and for China, the world’s greatest carbon emitter) as compensation for the West’s environment spoliation.
President Obama claims to be reducing the taxes of 95 percent of Americans, which is bunk. The combination of constant, easily exposed untruths and harebrained legislative nostrums is vaporizing the political capital a president needs to execute his office effectively. Any person of average intelligence can see that real health-care reform will require either that corporate health-care plans beyond a high level of care be taxed, or at least that they all be paid by the plan members themselves and made tax-deductible. As long as he who pays is not who receives the benefit of health insurance, the upward pressure on costs, already $3,000 per capita more than in any other advanced country, will continue.
The same person can see that competition has to be expanded by abolishing the often corrupt and always costly insurance protectionism of the states, and opening up the whole country to interstate medical-care-insurance competition. And anyone can see that serious health-care reform will require tightened malpractice criteria and capped awards. Yet the administration has caved to union objections to taxing enhanced health benefits, and to the trial lawyers’ objection to interfering with their happy hunting ground of contingent-fee malpractice suits. The Republicans appear to have joined the abdication by agreeing to the deferral of taxing deluxe plans to 2018: a complete, bipartisan, equal-opportunity, no-fault common front of airtight official cowardice.
The president bellows warnings against runaway deficits and proposes more vertiginous deficits. If he wanted to start positive momentum — and convince the world that the U.S. is not about to wash out its own currency, or induce another recession — he would push for taxes on financial transactions, elective energy sales, high-end medical benefits, and non-essential consumer spending; move for a gradual increase in the age for drawing Social Security benefits, to reflect the 15 percent increase in life expectancy since the 1930s; and undertake a serious imposition of spending restraint.
This president knows that the only ways to lead in defiance of current opinion are a) to accomplish the objective by stealth (as Lincoln did with Emancipation, and as Roosevelt did with his war policy in 1940–41) and b) to lead public opinion to a new stance, as Harry Truman did with the Marshall Plan and NATO, Lyndon Johnson did with civil rights, and Ronald Reagan did with missile defense. There is something wanton, if not mad, in the president’s relentless pursuit of what the people know to be nonsense. His new approach to medical care is a revival of his failed policy, now to be put through by recourse to outright procedural chicanery. This is a terminal case of the great liberal death-wish: disingenuous sloganeering on behalf of a bad and unpopular plan, foisted on a democratic country by trickery. While the House Speaker’s ability to deliver majorities for insane legislation should not be underestimated, even the ciphers of the Pelosified Democratic House majority may not wish to simulate dropping flies on Election Day for this cause.
Instead of change, we have had a deterioration of what was already dysfunctional: paid-for congressmen in rotten boroughs, trading earmarks with abandon, and a president trying to impose a mandate that he did not receive, for bigger government. It is little wonder that such respected senators as Evan Bayh and Lincoln Chafee — Democrat and Republican respectively, and both sons of senators — have in recent years tired of the Senate. But the answer to their ennui is not, as Senator Chafee suggests, an independent party. They have never succeeded, and the Republican replacement of the Whigs (Abraham Lincoln was a Whig congressman), which he invokes, is not the relevant precedent. William Lemke, Strom Thurmond, Henry and George Wallace, John Anderson, and Ross Perot are.
America and the world cannot wait indefinitely for a return of grown-up government in Washington. And if Barack Obama does not raise his game, he not only will be a failed president — not a novel experience for this country — but will set back the political progress of the African American, of which his election was such uplifting evidence.