This is Paul Ryan's moment. If national security or social policy were at the center of debate, the Wisconsin congressman wouldn't be nearly as prominent as he is today. But President Obama wants to reshape the American economy and welfare state so that it looks more like a Western European social democracy. And since fiscal policy is Ryan's specialty, he's become the GOP point man when it comes to entitlements and health care. I continue to get emails from readers applauding Ryan's performance at the health care summit a week ago. Type Ryan's name into Google search and the fifth prompt that comes up is "Paul Ryan for President." (Ryan says he won't run in 2012.)
Then there's health care reform. Ryan's deconstruction of the claim that Obamacare reduces the deficit has become a minor YouTube classic. The Wall Street Journal reprints Ryan's remarks in today's paper. Democratic politicians have not bothered to refute Ryan's arguments -- they've left that job to liberal bloggers. But even the Washington Post's Ezra Klein concedes "the 10-year cost of the bill is really only counting six years of operation" and does not question Ryan's $2.3 trillion Obamacare price tag. Klein says, instead, that Ryan "omits the information that's actually relevant for his presentation on cost control and deficit reduction."
Which information? That would be the Congressional Budget Office's conjecture that health care reform could reduce the deficit by as much as a trillion dollars in its second decade of operation. But that estimate was always couched in uncertainty. Here is the CBO:
These longer-term calculations assume that the provisions are enacted and remain unchanged throughout the next two decades. However, the legislation would maintain and put into effect a number of procedures that might be difficult to sustain over a long period of time.
Those provisions include the "Doc Fix" reduction in Medicare reimbursement rates and the Independent Medicare Advisory Board (IMAB) which would mandate future reductions in Medicare. "Doc Fix" has never happened. And "the projected longer-term savings for the legislation also assume that the Independent Payment Advisory Board is fairly effective in reducing costs beyond the reductions that would be achieved by other aspects of the legislation," CBO wrote. You know what happens when you assume! We don't know what will happen tomorrow. How can we say with any certainty what will happen 11 to 20 years from now?
"There is nothing more exhilarating than to be shot at without result.” Republicans and conservatives have recently had reason to appreciate the truth of Winston Churchill’s statement. President Obama and the Democratic Congress had a real shot at transforming American politics and public policy into European-style social democracy. When Obama spoke to Congress a year ago, on February 24, 2009, it certainly seemed he would have a chance to succeed.
The “health-care summit” has come and gone, and it was a good day for the Republicans. They were sharp and focused, the Democrats meandering and ineffectual. The latter came off more like wishful ideologues or naive amateurs than like practical realists with sensible solutions. They seemed disconnected from economic and budgetary realities, and from the electorate. Politico’s Chris Frates writes that “Disciplined Republicans came off looking more like principled opponents than foaming-at-the-mouth obstructionists,” that the “Democrats focused on the ‘why’ of health reform instead of the ‘how’,” and that “The meeting itself didn't provide much new cover for wary red-state Democrats.”
One of the great things about the health summit was getting to witness certain members' rhetorical skills and getting to hear how they think about things. One of the most revealing comments was made by Senator Tom Harkin (D-Iowa), who lamented that people whose medical bills are higher have to pay more, as this constitutes "segregating people on the basis of health." He added, "It's time to stop that kind of segregation in our country."
The message coming out of the health care summit is clear: President Obama and the Democratic leadership are planning one, last-ditch effort to restructure one-sixth of the economy by using the parliamentary tactic known as reconciliation. This jibes with Mike Allen's report from this morning. Obama is betting that Nancy Pelosi will find 217 votes to pass the Senate bill despite the public's disapproval.
Why is the health care reform summit going over time? The answer is simple: President Obama. He's decided to try to refute -- at length -- every single Republican criticism of the Democratic health bill. (The only exception: Paul Ryan. In that case, Obama quickly changed the subject to Medicare Advantage.) Obviously, this is Obama's prerogative as president. And in some cases he's made good points. But he could easily have let the other Democrats at the table make those points for him. The truth is, Obama can't help himself. He never misses an opportunity to prove that he's the smartest man in the room.
One of the more amusing side-plots to the health care reform summit has been the constant annoyance of Rep. Charles Rangel, Democrat of New York, that Obama hasn't called on him yet. As Rep. Jim Cooper, Democrat of Tennessee, was speaking, you could hear Rangel protest to the president that he hasn't had a chance to talk. Cooper's a soft-spoken man, so you could also hear an irritated Obama inform Rangel that he has to wait his turn. Maybe Rangel is in a hurry to get back to one of his four rent-controlled NYC apartments.
During a relatively succinct (for him) presentation on health care costs and deficits, Vice President Joe Biden had a great, Shatnerian line. "Medicare," he said. "It exists."
The change in the president's demeanor over the course of the health care summit is striking. This morning, the president was sunny and friendly. By the time John McCain spoke around noon, however, the president was clearly angry.
President Obama is frustrated. He chastised Sen. Jon Kyl, the minority whip, and Rep. Paul Ryan of Wisconsin for making the health care debate about whether Washington knows best. That "tips the scales," Obama said (I'm quoting from memory), because "everybody is angry at Washington right now."
Exactly! Everybody is "angry" at Washington right now because government is doing too much and producing too little in the way of results. Yes, the dismal economy adds to that anger. But the administration's economic program has not promoted private sector job creation, and Democrats are fixated on health care reform while the public's top priority is the economy. No wonder the public is upset. The disconnect between what is happening in Washington and everyday life across the country is jarring. And Obama just doesn't get it.
At the health care summit, Senate minority leader Mitch McConnell just pointed out that Democrats have monopolized the speaking time so far. President Obama correctly replied that McConnell was right. The Democrats had longer opening statements "because I'm the president." Everyone chuckled.
This event showcases the president's strengths: he's a great communicator, he knows the material, and he is always willing to treat the opposition in a friendly manner. But it also highlights his weaknesses: He's too much the lecturing professor, and he mistakenly believes a bunch of men and women sitting around a table in a house on Pennsylvania Avenue can effectively manipulate the lives of 350 million diverse Americans.
Before Sen. Tom Coburn, Republican of Oklahoma, began to talk about costs, President Obama and Sen. Lamar Alexander, Republican of Tennesse, engaged in a high-profile debate over the effects of the Senate legislation on the cost of premiums. Sen. Alexander said the Congressional Budget Office has found that individual premiums would rise as a result of health care reform. Obama said Alexander's wrong, premiums will go down. Who's right? From what I can tell, they both are.
During the Democratic primary race, it was Hillary Clinton whose health-care plan used an individual mandate to increase health-care coverage.
Back then, it was Barack Obama who argued against a mandate because it put onerous penalties on those who already could not afford health insurance. His argument was that the impediment to access is "affordability," and lowering costs would necessarily lower that impediment.
President Obama is genial, charming, and respectful of his opponents. Not Senate majority leader Harry Reid. He's a nasty hyper-partisan who regularly launches personal attacks against Republicans. And he wasted no time singling out Sen. Lamar Alexander, Republican of Tennessee, in his opening remarks at the health care summit. Reid made Nancy Pelosi look like a model citizen.
Reid kept saying that Sen. Alexander is "entitled to your own opinion, but not your own facts." Which facts are those? Reid cited a Kaiser Foundation poll showing that large majorities would be disappointed if Congress did nothing on health care. But that same poll also shows support for health care reform sharply divided and majorities saying the current bill won't improve their condition.
Facts are stubborn things, Sen. Reid. And not all of them are on your side.
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