Max­i­mum achiev­able dam­age

The Washington Times Weekly - - Commentary -

Does any­one re­mem­ber the TV show “Su­per­mar­ket Sweep”? Con­tes­tants would com­pete with one an­other by ca­reen­ing through a su­per­mar­ket and grab­bing as many prod­ucts as they could toss into a bas­ket. The win­ner was the shop­per whose cart car­ried the big­gest price tag when the bell sounded.

It’s a fit­ting im­age for the way Nancy Pelosi and Harry Reid have han­dled the most im­por­tant do­mes­tic is­sue of the decade. They’ve raced down the health pol­icy aisles, sweep­ing items off the shelves and into their leg­isla­tive carts, heed­less of nu­tri­tional value, taste, or cost. As items dropped out on the hair­pin turns, oth­ers were shoved into the spa­ces. Harry Reid in­serted the Medi­care “buy-in” at the 11th hour and just as quickly with­drew it un­der pres­sure. No or­ga­niz­ing prin­ci­ple has gov­erned the con­tents of their bas­kets (Mrs. Pelosi added and jet­ti­soned abor­tion cov­er­age), just an ur­gent im­per­a­tive to pass some­thing. And now, as the clock winds down, they are declar­ing, as a jour­nal­is­tic cheer­leader at the Wash­ing­ton Post put it, “a leg­isla­tive feat of epic pro­por­tions.”

Ac­tu­ally, it was the slop­pi­est and most slap­dash leg­isla­tive process ever to ac­com­pany a ma­jor bill. The 383-page man­ager’s amend­ment, mak­ing changes to the Se­nate bill, was re­leased on the morn­ing of the clo­ture vote. Se­crecy marked Mr. Reid’s han­dling of the bill through­out. Not only Repub­li­cans, but Democrats, too, were kept from study­ing the leg­is­la­tion. Pay­offs to wa­ver­ing Sens. Lieber­man, Lan­drieu, and Nel­son, on the other hand, were bla­tant.

The Demo­cratic leaders of the House and Se­nate, in con­cert with the White House, have bul­lied, bribed, and rushed their mem­bers to vote on this leg­is­la­tion so that the deed could be done be­fore con­stituents — who op­pose it force­fully — could con­front their rep­re­sen­ta­tives face-to-face over the Christ­mas break.

The Democrats have en­dured bruis­ing in­ternecine con­flicts and risked the loss of be­tween 20 and 40 seats in 2010 (Mrs. Pelosi’s es­ti­mate) for this. And what have they achieved? Their goal — a sin­gle-payer sys­tem or a glide path to one — re­mains as dis­tant as ever. In­stead, they have pro­duced (or will, af­ter the con­fer­ence com­mit­tee) an enor­mous new $2.5 tril­lion oc­to­pus of fed­eral reg­u­la­tion that will in­crease pre­mi­ums, con­trib­ute to med­i­cal cost inflation, re­duce qual­ity and choice of care, and deeply politi­cize an as­pect of life that most Amer­i­cans re­gard as sacro­sanct. Ad­di­tion­ally, and most alarm­ingly, it will ag­gra­vate the al­ready crush­ing debt we are ac­cu­mu­lat­ing.

Pres­i­dent Obama has be­trayed ev­ery ring­ing prom­ise he made about this re­form. Peo­ple will not be able to keep their health plans if they are happy with them. The fed­eral gov­ern­ment will de­ter­mine which plans pass muster. As for not adding one dime to the fed­eral deficit? Ris­i­ble. The “sav­ings” in the Se­nate bill con­sist of cuts to Medi­care, not in­creased com­pe­ti­tion or more ef­fi­cient de­liv­ery of ser­vices. And while CBO has scored the bill as re­duc­ing the deficit, CBO must abide by the as­sump­tions Congress presents. It can­not say what we know from his­tory to be the truth: Congress will not make cuts in Medi­care. Be­sides, ev­ery en­ti­tle­ment ever en­acted has wound up cost­ing or­ders of mag­ni­tude more than the es­ti­mates at pas­sage. That’s why the Medi­care and So­cial Se­cu­rity un­funded li­a­bil­ity is cur­rently $107 tril­lion, ac­cord­ing to a 2009 trustees’ re­port. The Reid bill will add at least 15 mil­lion new ben­e­fi­cia­ries to Med­i­caid, ac­cel­er­at­ing that pro­gram’s bud­get-bust­ing mo­men­tum.

The pres­i­dent also promised that no one earn­ing less than $250,000 would pay higher taxes. But un­der both the Se­nate and House bills, peo­ple who do not pur­chase health in­sur­ance will be slapped with an ex­cise tax (2.5 per­cent of ad­justed gross in­come un­der Pelosicare, and $750 or 2 per­cent of in­come, whichever is larger, un­der Rei­d­care).

The Democrats have not achieved their goal of com­pletely las­so­ing one-sixth of the econ­omy, but their mam­moth leg­is­la­tion (the House and Se­nate bills both top 2,000 pages) will ap­ply heavy-handed reg­u­la­tion that will fur­ther gum up a sys­tem al­ready chok­ing on bu­reau­cracy. Amer­i­cans will be forced to buy health in­sur­ance. In­sur­ance com­pa­nies will be for­bid­den to price their ser­vices ac­cord­ing to ac­tu­ar­ial ta­bles. And no as­pect of med­i­cal care will be free of po­lit­i­cal in­ter­fer­ence. (One sec­tion of the Se­nate bill re­in­states cov­er­age for DXA scans be­cause two se­na­tors in­sisted upon it. An­other re­quires breast­feed­ing breaks in the work­place.)

The Democrats will cre­ate, among oth­ers, the fol­low­ing new bu­reaus: The Grant Pro­gram for Health In­sur­ance Co­op­er­a­tives, the Telehealth Ad­vi­sory Com­mit­tee, the Com­mu­nity Based Med­i­cal Home Pi­lot Pro­gram, the Cen­ter for Com­par­a­tive Ef­fec­tive­ness Re­search, and the Qual­i­fied Health Ben­e­fits Plan Om­buds­man. In short, Democrats have done the max­i­mum amount of dam­age to our sys­tem that they could man­age un­der the cir­cum­stances.

Mona Charen is a na­tion­ally syndicated colum­nist.

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