Saturday, November 21, 2009

Who Will Win The Healthcare Vote?

For Politico's "Arena" section:

And the winner of the healthcare vote tonight is going to be … politics. In my view, that’s a good thing. Or, more precisely, it’s a good start. In America, the people should rule--and the American people want more healthcare, not less; 67 percent of Americans don’t think they are getting the treatment they need, and only 16 percent think they are getting too much treatment, according to the Kaiser Family Foundation. Powered by lopsided numbers such as those, the voters will eventually win this fight. Indeed, they already are winning it.

So what we have seen, and what we will continue to see, is the gradual peeling back of all the rationing and rationing-esque “reforms” dreamed up by the national policy elites. Those elites are plenty smart, but the grad-school group is committed to an intellectual model that the American people reject. Think of it as the healthcare equivalent of cap-and-trade--that is, a too-clever-by-half scheme that works well on a Cambridge chalkboard, and nowhere else. Those politicians who are overly impressed by eggheads and foundation-money glitz might buy into avant-garde claptrap for a while, but eventually, the more survival-oriented politicos will read the unmistakable smoke signals wafting up from the flyover folks: “Knock it off!”

A healthcare case in point is the thundering repudiation of breast-cancer-screening guidelines this week. It’s hard to think of a purer example of the gap between policy and politics: The policy experts, conclaved in some ivory tower, and seeking to do their part to advance the rationing agenda, issued guidelines that were immediately cut down by opposition fire, like British Tommies at the Somme. The guidelines were machine-gunned by politicians of both parties, reflecting not only public opinion, but also much media opinion. Hats off, in particular, to ABC’s Robin Roberts (herself a breast cancer survivor).

Meanwhile, as context, President Obama, like President Clinton before him, is still plodding forward, with General Haig-like determination, despite bleeding heavily in the polls. Obama, a clever fellow but not much of an historian, seems serenely happy following a doomed downer of a plan.

But as noted, the political class is wising up: If the American people want more healthcare, then the risk-averse-est course is to give them what they want. And that’s why all the cuts are fake, destined to be overturned by this Congress, or any and all future Congresses. It’s the triumph of politics, as a long-ago budget cutter, David Stockman, once ruefully described it.

Some day, maybe, the policy class will figure out how to turn fiscal lemons into economic lemonade. That is, if people want to live longer and healthier lives--not only in the US, but around the world--then that’s a good thing, not a bad thing. Whole new industries could be created, providing jobs and growth, as well as better medicine. The American people can’t quite articulate that bright future, because that’s not their duty; it’s the duty of the thinking classes. But as we have seen, the thinking classes are on their own ideological jaunt, quagmiring down in the deadest of political dead ends.

So in the meantime, the American people will watch--that’s all they can do. They will vote “no” on rationing foolishness, and so will their elected representatives. And if someone puts a better medical model in front of them, they will happily vote for that.

That day will come, and it can’t come soon enough.


  1. Looks like you are signing up for a Marxist view of history (which isn't the same as Marx on economics): history as a process of contradiction resolving into contradiction. Those who want "comprehensive reform" are putting themselves on the side of the people this time, setting up a contradiction between the unlimited desire for more and the first principle of economics: scarcity. If we want to get ahead of the game, we can speculate about how the contradiction in this round of health care reform will resolve itself.

  2. It is no easy subject that you are writing on Jim. What we need is a diagram-drawings for rebuilding health care from the foundation up, like a house. AND IT'S FOOTING MUST START WITH TORT REFORM. Losers pay, awards are capped and medical personnel can't practice without a Federal License.
    Otherwise, I see it as all Blarney by two-bit gangsters hiding behind the American flag making a buck on the aching backs of my fellow Americans and in the future, my grand kids.
    The Hill People started this because 15% of Americans weren't covered. They are upsetting the whole bloody system and 16% of our nation's economy. Yet the bill tonight doesn't address 15 uninsured Americans, it addresses only 9. The other 6 of the 15 are still screwed.
    Months ago I said:
    Let the uninsured go to doctors.
    Let the doctors send these bills to the IRS.
    Let the IRS give the doctors, say, a 30% tax credit.
    Any excess tax credits can be used to buy medical equipment.
    Non-Profits can do the same.
    Who will win the Healthcare vote? Not the American people. But come next November, The Hill People will be the losers! Then we will rebuild the house with the proper footing.