The Messianic Promises of Public Health Care

By the Editors

As absurd as many of its specific grievances may be, one can excuse the American public for many of the misgivings it expressed about the Democrats’ health plans this summer. Claims, short on facts, by charismatic leaders that they can heal you in ways yet unknown to man often lead those believing in them to soporific draughts of Kool-Aid. Congressional Democrats along with their allies further left may blame their late difficulties on the dark machinations of insurance compa­nies and the right-wing conspiracy, but the nearest well-lit mirror will reveal their strongest foe.

If nonsense about “death panels” were the strongest objection, the supporters of the present re­forms would have no doubt of victory. Nasty falsehoods are often on their face the most extreme objection to any plan, but they are the most easily disposed of. They’re going to make grandma drink the hemlock? Just show them the text of the bills—admittedly a bit taxing on the attention span in this circumstance—and the objection is forever dead; grandma—and the proposal—lives. The Democrats’ big problem is not their opponents’ groundless claims, it is their own.

The plans have only two real effects that anyone might reasonably desire: They will extend cover­age and transfer more of the cost of health care from the poorer to the richer and from the sicker to the healthier. Yet strangely the Democrats, particularly President Obama, have decided that their chief selling point should be something that their plans do not do at all: control health care costs. Selling ice to Eskimos is tough, but claiming that it’s actually fire only compounds the problem.

When the non-partisan Congressional Budget Office’s Douglas Elmendorf presented its findings on the emptiness of this key claim, most of the true believers treated the claims less seriously than if they had been some bite of talk-radio venom. Indeed, Senate Majority Leader Harry Reid responded with the school-boyish retort, “Maybe what he should do is run for Congress.”

Then, there is the insistence of many on the talismanic “public option.” As earnest as its backers may be, none have given a truly coherent justification. The limited success of current government health care programs, particularly Medicaid and the Veterans’ program, make Mr. Obama’s suggestion that private insurers and the public option might get along like the Post Office and far more profit­able and efficient private parcel carriers look unknowingly prescient. Some claim a public option would somehow keep private insurers “honest”—something, in their view, no amount of competition between private insurers or public regulation could do. Yet, the memory, still fresh and smarting, of Fannie Mae and Freddie Mac’s role in the mortgage-backed security crisis hardly supports the view that publicly backed companies confirm their private brethren in moderation.

Moreover, the Democrats have, albeit less skillfully, adopted many of the political tactics they accused the Republicans of using during the Bush years. They insist that the crisis is so great and im­mediate that we must forgo extended discussion. Besides, as Mr. Obama asserts, you shouldn’t even listen to those who allegedly got us in the present predicament, by which he seems to mean anyone who opposes his agenda. Moreover, if someone writes something “fishy” about the plan, report it the White House. (Never mind that you could cull more than a few such statements from Mr. Obama’s speeches.) And if your opposition is too vocal, as Speaker of the House Nancy Pelosi would say, you’re simply un-American.

Evidently, the real problem is the chasm between the substance and the message, which reflects the central tension of the Obama Presidency. The substance is mostly unreconstructed liberalism: chase af­ter the distortions caused by regulation with even more regulation; subsidize the health care of people who can probably afford it themselves; create new entitlements whose costs are liable to balloon when we can hardly control the costs we have. But the language tries the dainty way of Clintonian triangula­tion: This is all about giving the middle class choices and helping it control its health care costs. Pro­claiming a post-partisan age while clinging to a tired partisan agenda could fool enough people during the elections, but when it comes to actual policy-making, words must cede to the thing itself, and then the truth is before the eyes of all. Many of the silly claims bandied about by town-hall protesters are only a bit sillier than the ones their congressmen were there to persuade them of.