It took a seedy campaign of intimidation, bribery, and back-room deal-making worthy of Tammany Hall, but Democrats have nearly pulled off the radical transformation of the American health care system that they – if not the rest of America – so desperately desire.
With yesterday’s 219-to-212 party-line House vote, made possible by the last-minute collapse of a holdout block of anti-abortion Democrats led by Michigan Rep. Bart Stupak, the federal government’s intrusion into one-sixth of the economy is one step closer to becoming a reality. All it cost the Democratic majority was the prospect of fiscal responsibility, the pretense of bipartisanship, and any remaining confidence that the American public may have had in its elected representatives.
Sunday’s legislative “victory” was achieved despite the flaws of the House health care bill, which are by now well-documented. Of these the most notable is the staggering ten-year price tag for the legislation: $940 billion, complete with tax increases totaling $400 billion. Even in its enormity, that figure does not factor in the expensive new federal bureaucracy that the bill would create. For instance, some 16,500 new IRS workers will be needed to collect, examine and audit the new tax information that families and small businesses will have to provide to comply with the bill’s provisions. Nor does it include the penalties – up to $700 in some cases – that Americans will be forced to pay lest they fail to purchase insurance.
Billions in new entitlement spending may seem troubling, especially during an economic recession, but Democrats have sought to dismiss any anxiety about the health care bill’s effect on the deficit. To that end, Democrats spent the week gleefully touting the Congressional Budget Office’s projection that the House bill would reduce the deficit by $138 billion over ten years. If CBO projections could be taken at face value, that would be encouraging news. But as the Washington Post reported, the real budget outlook is far more dire, since the CBO’s estimates are based on the expectation of savings and cuts that may not come to pass. Medicare is a prime example. While CBO estimates factor in cuts in Medicare reimbursements, such cuts are politically unlikely and, indeed, no Congress in recent history has dared to make them. Assuming that those cuts will take place this time around is little more than wishful thinking. As it stands, the health care overhaul seems more likely to confirm another of the CBO’s projections: that public debt will rise to 90 percent of GDP by 2020 under President Obama’s budget.
As awful as the substance of the House bill is, the process by which it was passed may be even worse. By embracing a series of shady procedural stratagems – from the dubiously constitutional “deem and pass,” in which the Senate version of the health care bill would be deemed to have passed without the formality of an actual vote, to “reconciliation,” usually reserved for budgets of bills that are already law – Democrats sowed widespread distrust and even alienated some media allies. At the height of the health care subterfuge, even the Washington Post was stirred to editorialize against the Democrats’ “unseemly” tactics. If last night’s vote was, as House Majority Leader Steny Hoyer suggested, the conclusion of “a national conversation” on health care, it was a conversation carried on largely without the nation.
This go-it-alone arrogance, magnified with unprecedented media coverage, sheds light on the profound cynicism that has set in with the American public. A new NBC News/Wall Street Journal survey finds that 76 percent of Americans do not trust the U.S. Congress. That distrust extends to health care. Polls show that the plurality of the American public opposes the health care reform efforts in Congress – a striking statistic when one considers that the need for the reform was one of the few original points of consensus in the health care debate. With their scorched-earth campaign to pass the bill, Democrats have almost singlehandedly destroyed a once-promising political landscape. The Tea Party protestors who flocked to Capitol Hill yesterday to voice their opposition were only the most visible sign of the public’s sour mood.
To be sure, ObamaCare is not yet the law of the land. The companion legislation to the House bill still needs approval in the Senate. There, the Democrats’ majority is far more tenuous, thanks to the recent of Massachusetts’s Scott Brown on the campaign pledge of opposing ObamaCare. But if the House vote sets any kind of precedent, it is that Democrats will stop at nothing to force through their signature legislation.
Whatever the ultimate outcome of the health care battle, the democratic process has clearly become a casualty. The American public is more cynical about its government that at any time in recent history. Next fall’s elections may yet bring a measure of retribution for the Democrats’ overreach. But by then the damage – all $940 billion of it – may be irreparably done.