Well, so much for the pivot to jobs. Late last week, the Obama administration and congressional Democrats made clear that, rather than turn to voters' economic concerns in this winter of discontent, they want to persist in pushing the health care proposals they have championed for a year — proposals voters have rejected by every means at their disposal, from expressing (a still growing) opposition in polls, to scolding members of Congress in town hall meetings, to handing Ted Kennedy's Senate seat to a Republican.
It is now clear that the “summit” the president has called for February 25 is not intended to consider different approaches to health care financing, but rather to create an illusion of momentum that might just lull disoriented congressional Democrats into ramming the health care bill through the budget reconciliation process.
Leading up to the summit, Harry Reid, Nancy Pelosi, and White House officials aim to produce a bill that bridges not the yawning gap between Democratic and Republican proposals but the technical differences between House and Senate Democrats. The House and Senate bills do differ on some issues — a government insurance plan, the details of tax increases and Medicare cuts — but they agree on the big picture, which would be the essence of a combined bill: a massively ambitious, costly, intrusive, inefficient, and clumsy combination of mandates, taxes, subsidies, regulations, and new government programs intended over time to replace the American health insurance industry with an enormous federal entitlement while failing to address the rising costs at the heart of our health care dilemma.
It would raise taxes in a tough economic time, cut Medicare benefits without putting the program on a sustainable footing, create a new open-ended entitlement as we confront daunting deficits, and displace the insurance arrangements of millions.
The public has had a good look at all this for a year, and has hardly been tentative in its judgments. A clear majority in every major poll this year has opposed the Democrats' approach. Approval for President Obama's handling of health care is just 36 percent, according to the latest CBS News poll. The Democrats have witnessed the transformation of one of their strongest policy issues with voters into one of their weakest, and in the process have lost the trust of voters. But their leaders nonetheless seem committed to forcing their health care agenda down the public's throat.
The timing of this move (just after a congressional recess, when members of Congress won't be spending much time at home again until Easter), the nature of the health care summit (a public relations spectacle intended to generate buzz in the political press more than to appeal to the public), and the character of the legislative plan (a quick hard push through reconciliation to avoid debate, amendments, and too much time to think) all seem designed to bamboozle rank and file Democratic members of Congress into taking a suicidal vote. But they are also aimed to slip the bill past the public, not yet alert to the danger. This stratagem is the perfect finale to a yearlong circus that has exposed the ugliest side of our politics.
With their plans to press ahead now clear, the Democrats have given Republicans little choice but to restate the full indictment of Obamacare at the summit and beyond. They might start with the Democratic push to cut Medicare Advantage benefits, forcing millions of seniors out of the coverage they enjoy today as early as this fall. They could follow that up by highlighting the deal to exempt union workers' health plans from the “Cadillac tax” through 2017, which is said to be crucial to House liberal support. This giveaway is worth $60 billion over a decade to the Democrats' big labor benefactors and will be rightly viewed as outrageous by the vast majority of Americans who are not in union plans. Of course, there's also the job-killing employer mandate, the regressive requirement to buy insurance, the regulations that will drive up premiums for the insured, and on and on. There is certainly no shortage of material to make the case — and contrast it with the conservative health agenda.
One way or another, this ill-advised legislative process is nearing its end. It will either conclude with the Democrats putting their blinkered and misguided proposal aside, at last to pursue genuine, incremental, modest, and practical health care reforms addressed to the actual problems our system confronts, or it will end with the passage of a ruinous bill rejected by the public and likely to exacerbate both the collapse of our public finances and the explosion of health insurance costs.
It is now up to Republicans and the many Democrats in Congress who increasingly see the folly of their leaders' ways to make sure this process concludes not with the enactment of Obamacare but with the initiation of a real health care debate. Listen to the voters: Scrap this bill and start over.
James C. Capretta is a fellow at the Ethics and Public Policy Center and a health policy consultant. Yuval Levin, also a fellow at EPPC, is the editor of National Affairs.