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April 16, 2010 [LINK / comment]

Health care "deep thoughts"

Even though the "Patient Protection and Affordable Care Act" has become the law of the land, the debate over it goes on and on. What follows are a random collection of comments I've written on various Facebook friends' pages recently. For example, many Republicans are demanding that their party's candidates pledge to seek repeal of Obamacare as a condition for getting financial support from the party. While I would like to see that happen, I am very dubious about any legislative remedy, and think the only hope lies in our court system:

As Kevin said, federal entitlements are 99% immune from repeal. The battle in Congress is over.

To the extent we are becoming a majoritarian democracy, we would expect courts to refrain from deciding controversial political issues. But how do Brown v. Board of Education and Roe v. Wade fit into that? Conversely, to the extent we still remain a republic in some meaningful sense, courts would exercise their proper role in upholding constitutional limits on power. I remain hopeful that SCOTUS will do its duty and preserve our body politic, but it hasn't fulfilled that role since the 1930s at least.

The only conclusion I can draw is that we are being transformed into a tyranny of the majority, the composition of which is highly fickle, inattentive, and subject to manipulation by various elites. Anyone with knowledge of the classics (or even just Federalist #10) knows what this implies for our future: increasing factional polarization, violence, chaos, and national decline.

Now why won't those who ridicule us dissenters at least acknowledge that our present situation is exactly what our Founding Fathers warned us about?

Andrew Murphy is among the thoughtful, independent voices I have come to respect, but I think he (and another Facebook friend, Bruce Bartlett) are far too sanguine about the hazards that are likely to accompany Obamacare. They seem to think it will all work out, somehow. I wrote on Andrew's page:

The health care law cannot stand as it is, because neither the private insurance companies nor the Democrats really trust each other. The companies will gladly take all the new customers, while squeezing out as much profit as they can before they are completely taken over. If the Dems and moderate Republicans had agreed to a limited public option for poor people without a mandate, it might have worked. I would have opposed such a measure, but at least it would not have been as bad as the coercive provisions in the new law.

Later, I elaborated further to clarify my thinking:

@Murphy - My objection is based primarily on efficacy, not philosophy. The main reason health care costs are spiralling out of control is that Americans over overinsured, leading to excessive testing and treatment, and the implicit subsidies via tax-exempt employer contributions to health insurance premiums creates an unstoppable vicious cycle. Republicans refuse anything smacking of a tax hike, so taxing those benefits are off the discussion table.

Instead of public insurance to let poor participate in a system that has gone haywire, there should be an expanded (free or cheap) public health service. Ideally, we should move away from relying on health insurance for routine doctor visits and prescriptions, which would at least give a chance for market mechanisms to work, but thanks to GW Bush and "compassionate conservatism," we are totally screwed

On another discussion thread on either Andrew's or Bruce's page, I took issue with the idea that the United States could emulate the public health care system in Hong Kong:

Fima understands what those who think Obamacare couldn't be worse than the status quo don't. The new law takes a hideously dysfunctional, wasteful Federally-mandate[d] private insurance system and expands it to become nearly universal. It is self-contradictory and can't possibly last, presumably just a first step toward a single-payer system.

If our political system weren't bogged down in a patchwork of crooked entitlement programs, there might be hope for a modest-scale public health system a la Hong Kong. T.R. Reid did a very good PBS documentary comparing Singapore, Taiwan, Switzerland, and Germany (I think) a few months ago. Under the right political circumstances, i.e., broad devotion to the public interest and respect for constitutional limits, it might be possible here.

As to Doug [Mataconis]'s reference to Hong Kong's political subservience to Beijing, it is a core belief of libertarians that free markets engender political liberalization. That is the Great Gamble of American foreign policy today...

April 15 Tea Party

Former Senator and Governor George Allen headed the list of speakers at the Tax Day event sponsored by the Shenandoah Valley Tea Party Patriots in Staunton yesterday afternoon. He spoke about energy self-sufficiency, but the main theme of the day was resisting the growth of government. According to the News Leader, about 800 people showed up, but I was not one of them. I had a very good reason for missing the event: I was doing my taxes! smile And in answer to the obvious question, yes I am "Taxed Enough Already!"

Blogger Andrew Sullivan had a surprisingly even-handed take on the Tea Partiers:

Most of the rational tea-partiers accept that the GOP has been as bad -- if not worse -- than the Democrats on spending, borrowing and the size and scope of government in recent years. They repressed this anger during the Bush years out of partisan loyalty. Now, they're taking it all out on the newbie. It's both fair and also unfair.

Hew went on to criticize their opposition to Obama is based more on partisanship and cultural hostility than to concrete differences on policy alternatives, of which they offer very little. On Facebook, Bruce Bartlett challenged Tea Partiers to state their positions on Medicare entitlements and other vexing, hot-potato issues. My response to him:

Well, to be fair, what grassroots populist movement ever cared about nuts-and-bolts technocratic policy dilemmas? They are what they are. Sullivan is exactly right the Tea Party movement: "My view is that it's so amorphous that you can slice it any which way." I'll keep trying to scrutinize them without prejudice, though it will take some effort.

Speaking of prejudice, local "progressive" columnist Al Dahler wrote an especially harsh piece about conservatives in the News Leader a few weeks ago: "Far right's actions becoming more absurd." Ironically, I would agree that there is a dangerous, wacky element on the far right, but he lumps them in with conservatives in general. His piece provoked a sharp right-vs.-left diatribe, and here's the comment I posted:

Kudos to JubalHarshaw, RushTil2016, and rkeefe57 for responding to Mr. Dahler's tiresome smear of conservatives with facts and reason. For more relevant information to rebut his distortions, see [clickable link]

Hate is NOT the exclusive property of either political party or ideological perspective. To combat hate and reverse the polarization that is spawning a troubling rise of political violence, those of us who love this country must call out and denounce hate wherever we find it, even among those on "our" side. There is no excuse for propagating bigoted, condescending attitudes, as exemplified by Mr. Dahler.

Posted (or last updated or commented upon): 17 Apr 2010, 1: 32 AM

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