July 23, 2009

A Month of Gloomy Thursdays for Health Care Plan

Thursday is the day things tend to come to a boil on Capitol Hill. Members of Congress have been in town for three or four days; they’re planning their exits on Friday to meet other commitments; they’ve had a chance to talk and meet with one another and sample the moods of their colleagues.

This month, Thursdays have been very bad days for the Obama administration’s attempt to pass health care bills concocted by House and Senate committee chairmen.

On the first Thursday after Congress got back in session, July 9, 40 members of the Democratic Blue Dogs caucus sent House Speaker Nancy Pelosi a letter opposing any health care bill that would increase the federal deficit, fail to reform delivery systems, and not protect small businesses and rural health providers. Signers included two committee chairmen. The House bill, they wrote, “lacks a number of elements essential to preserving what works and fixing what is broken.”

On the next Thursday, July 16, Congressional Budget Office Director Douglas Elmendorf addressed those concerns in testimony on the Hill. He reiterated the CBO’s conclusion that the Democratic bills would increase the federal deficit, by something on the order of a trillion dollars over 10 years. And, no, the Democratic bills would not “bend the cost curve” – i.e., would not reform the delivery systems in ways that would cut costs. Pelosi and Barack Obama insisted, in foot-stamping mode, that their bills would really, really cut costs.

That same day, freshman Rep. Jared Polis of Boulder, Colo., sent Pelosi a letter signed by 21 House freshmen and one sophomore opposing the increased taxes on high earners imposed by the two House committee bills. “Especially in a recession,” the letter read, “we need to make sure not to kill the goose that will lay the golden eggs of our recovery.”

There are 256 Democrats in the House, with one vacant Democratic seat. Only five Democrats signed both the Blue Dogs’ and Polis’ letters. That means that 57 Democrats signed one letter or the other, pledging to oppose central features of the Democratic health care bills. Few, if any, Republicans are expected to support either bill. You do the math. The Democratic leadership seems well short of the 218 votes needed for a majority on the floor. No wonder House Majority Leader Steny Hoyer said it’s time “to go back to the drawing board.”

Obama and congressional Democratic leaders are blaming Republicans for their problem. Obama noted that Republican Sen. Jim DeMint and Weekly Standard Editor William Kristol want to “kill” the Democratic bills. But the Blue Dogs’ and Polis’ letters showed that the mortal threat comes from elected Democrats. Twenty-nine of the 57 letter signers defeated or replaced Republicans in 2006 or 2008. Thirty-three of them represent districts carried by John McCain in 2008.

What we’re seeing is the people speaking through their politicians. Obama and many Democrats assumed that the financial crisis would predispose most Americans to favor a larger and much more expensive government than we ever have had before.

A plausible hope for change, perhaps, but polling shows it hasn’t happened. The prospect of huge federal deficits extending out as far as the eye can see is not appealing to most voters. The prospect of having the health care sector of the economy designed by the people who gave us the $787 billion stimulus package is even less appetizing.

But we should not cynically underrate the importance of a strong argument, which may prevail despite the transcendent aura of a new president. Some of the Blue Dogs’ concerns may be parochial (rural health care), but they make a strong case, buttressed by Elmendorf’s expert testimony, that Congress should not rush to transform the health care sector at huge cost and with little cost-cutting effect. And the Polis letter signers’ concern about the negative macroeconomic effects of higher taxation of high earners can find support in the writings of Democratic, as well as Republican, economists.

What will this Thursday bring? We’ll wait and see what comes from the buzzing on Capitol Hill. In the meantime, as I read the text of the Blue Dogs’ and Polis’ letters, I suddenly heard the voice of the late Jack Kemp proclaiming at the 1984 Republican National Convention that if you subsidize something, you get more of it and that if you tax something, you get less of it.

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