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Health Care Lessons

Learned and lost.

9:21 AM, Jan 27, 2010 • By JEAN KAUFMAN
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(6) Americans turned on the 1993 bill because the information they got though misleading ads scared them with lies. This time as little information as possible should be divulged; speed and secrecy are of the essence.

But the Democrats forgot that remedies often have unintended consequences. When the requisite speed of passage turned out to be unattainable, the public not only began to learn (and be frightened by) many of the bills’ details, but detested much of the process by which the Democrats were driving them—the speed, secrecy, and buyoffs; the incoherent patchwork nature of the bills; and the lack of leadership by President Obama, who left the sausage-making to an openly corrupt Congress.

The greater the public distaste, the more it seems that many Democratic leaders are determined to bitterly cling to the flawed bills and do their best to pass them, whatever it may take—be it reconciliation, House approval of the Senate bill, more vigorous arm-twisting, or some combination of them all. They rightly fear that the votes Democrats have already taken, as well as the corruption in which they’ve already participated, have alienated so many voters that they are on course to lose the House no matter what they do now, much as they’ve already lost their 60th seat in the Senate. So if they must go down, why not depart in a blaze of glory, with the passage of health care reform as their swan song?

Forget the fact that both bills satisfy no one, not even their supporters. Forget that many objections made by opponents of the bills concern substantive issues reflecting differences in the basic philosophy of government that separates the two parties. Forget that the bills have been arrived at through processes so obviously corrupt, with secrecy so great, and accompanied by so many broken promises, that they have deeply and perhaps irrevocably tarnished the Obama administration. 

And forget the most fundamental fact of all: There might be something inherently difficult and even contradictory about the notion of universal health care that is comprehensive, affordable, high quality, and yet comes without a huge price; that there may be no way to slice the available pie into enough large and tasty pieces to satisfy everyone without resulting in national near-bankruptcy, as well as substantial and unacceptable loss of liberty. 

Dismissing such concerns with the sanguine reassurance that “all will be well, just trust us” is not enough. Maybe the problem with passing these bills is not merely strategic, and maybe most Americans will never approve. Maybe they would prefer more minimalist and gradual change, or even (gasp!) the implementation of some of the more modest proposals Republicans have suggested, such as interstate transportability of private health insurance, and tort reform. Maybe voters’ very real concerns are based on reality, not a reaction to scary rhetoric designed to frustrate the wishes of Democrats and halt the inevitable progressive sweep of history. 

But it is much too threatening to the Democrats’ long-held vision of universal health care at last to actually look at these facts. It might mean they would have to admit that they could be chasing a pipe dream, albeit one they’ve held close to their hearts for the better part of a century. 

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