David Frum writes:
What would it mean to “win” the healthcare fight?
For some, the answer is obvious: beat back the president’s proposals, defeat the House bill, stand back and wait for 1994 to repeat itself.
The problem is that if we do that… we’ll still have the present healthcare system. Meaning that we’ll have (1) flat-lining wages, (2) exploding Medicaid and Medicare costs and thus immense pressure for future tax increases, (3) small businesses and self-employed individuals priced out of the insurance market, and (4) a lot of uninsured or underinsured people imposing costs on hospitals and local governments.
We’ll have entrenched and perpetuated some of the most irrational features of a hugely costly and under-performing system, at the expense of entrepreneurs and risk-takers, exactly the people the Republican party exists to champion.
Not a good outcome.
Even worse will be the way this fight is won: basically by convincing older Americans already covered by a government health program, Medicare, that Obama’s reform plans will reduce their coverage. In other words, we’ll have sent a powerful message to the entire political system to avoid at all hazards any tinkering with Medicare except to make it more generous for the already covered.
He poses a thoughtful, forcefully stated argument that I’m going to ignore in favor of my latest hobbyhorse. If the GOP succeeds in blocking health care reform, Mr. Frum argues, “we’ll have sent a powerful message to the entire political system to avoid at all hazards any tinkering with Medicare.” He is probably right — that is the message politicians would take from a health care reform defeat.
But it isn’t the lesson they should take.
If health care reform is defeated, one lesson should be that it is easier to scare people in misleading ways when your legislative reform package is so ambitious, ill-defined, complicated and all-encompassing that confusion about what exactly it entails and the probably consequences are rational, even inevitable. Politicians should conclude that their time is better spent taking smaller, discrete steps to reform the health care system, even though incremental legislative efforts aren’t the stuff of historical legacies or televised ceremonies where parchment is signed with a fancy pen.
UPDATE: In a different post, David Frum gives an example of how hyperbolic and inaccurate attacks against liberals distract the right from criticizing and responding to the actual things for which it ought to critique the left.