It's OK if health reform destroys Democratic election chances for a generation

I thought this was interesting framing by Newt Gingrich in this morning's Washington Post:

But former Republican House speaker Newt Gingrich said Obama and the Democrats will regret their decision to push for comprehensive reform. Calling the bill "the most radical social experiment . . . in modern times," Gingrich said: "They will have destroyed their party much as Lyndon Johnson shattered the Democratic Party for 40 years" with the enactment of civil rights legislation in the 1960s.

As writer Dan Balz notes in the next paragraph, "no one doubts that Johnson was right to push for those civil rights measures." No one does now of course -- at least not openly, if they wish to participate in mainstream politics -- but the reason the civil rights legislation was so devastating for the Democratic Party over time was that there were plenty of people who did think it was wrong for Johnson to push for those measures.

What does this have to do with the health reform debate?

There's a lot about Republican governance the last 40 years that I've thought annoying at best and damaging to the country at worst. And yet the worst of it has never been so bad that it would justify hopping in a time machine and convincing LBJ not to pass civil rights legislation in order to keep the South in the Democratic column. The tradeoff -- 40 years in the political wilderness in exchange for a legal regime that protected and enforced the rights of African Americans for the first time in our history -- was worth it, frankly.

And if Gingrich's prediction comes true -- I'm not at all sure it will -- I suspect it will again be worth it. Millions of Americans who can't afford health insurance will finally be covered; millions of others who have paid for coverage will actually get to use that coverage instead of seeing it revoked when they get sick. A legal regime that enables all Americans to access and use health care is, frankly, the least that can happen in the richest civilization this planet has ever seen.

Republicans might be able to tap into anger among some voters to ride back into power. But it's unlikely they'll have the stones to repeal health reform -- last seen in power, of course, they were expanding the Medicare entitlement that conservatives had vociferously opposed a generation earlier. So they can have the presidency for the next 40 years, if they want. Power is important, but so is the end to which it is used. Democrats might be sacrificing their power now, but for a worthy cause. I'm OK with that.

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Republican governance?

You mean that "Republican governance" in which Democrats had huge majorities in both chambers of Congress for most of the 30 years between LBJ and 1994? Some "shattered" Democratic Party.

You mean that "Republican governance" in which we had a two-term Democratic president for pretty much the entire decade of the 1990s. And a one-termer in Carter. And a new Obama administration. And a Democratic Congress in both chambers starting in 2006 (taking over for a literally 50/50 Senate before that). Is that the "Republican governance" you're talking about?

Please, Joel. Don't take everything Newt Gingrich says so seriously — especially his tendency to exaggerate historic references. But Newt could have mentioned that Civil Rights legislation was a bipartisan affair, passing only because of support from the Republican Party. Democrats are really out on a limb here.

Re: Yup

I hear what you're saying, Jim, but I think it's generally acknowledged that the 40 years between 1968 and 2008 were a period of Republican ascendancy. Carter was the only real exception to that; after his health care failure Clinton generally governed in a way that more or less honored the Republican ascendancy.

An odd interpretation of history

Gingrich's reading of history is somewhat eccentric. I don't think your interpretation of what he's saying is quite correct, either, Joel. (And I could quibble with some details -- for example, everyone has access to health care in the United States, but not necessarily the health care they want; that fact will not change once the federal government runs health care in America.) But I fear your conclusion may be entirely on the money.

The Civil Rights Act of 1964 and the Voting Rights Act of 1965 were arguable federal interventions because several states simply refused to accord a class of citizens with equal treatment under the law. The reason those and other measures caused the Democrats such grief for the next 40 odd years was not racism simply, although there was doubtless plenty of that. Rather, it was the way in which interest group politics hardened into orthodoxy around the Democratic Party. And so what began with Lyndon Johnson's words at Howard University in 1965 -- "We seek not just freedom but opportunity. We seek not just legal equity but human ability, not just equality as a right and a theory but equality as a fact and equality as a result." -- evolved in just a few short years (under Richard Nixon's EEOC) into "affirmative action," goals, quotas, timetables, federally mandated busing, and the rest of it.

The result? A more centralize, more powerful, more politicized, far-reaching federal leviathan. The perversions of civil rights era reforms, what's more, aren't difficult to see. Here's one example, plucked from the pages of the latest issue of the Claremont Review of Books:

The incoherence of the now vast (Voting Rights Act) jurisprudence is legendary, and (Abigail) Thernstrom does a fine job detailing example after example of the absurd lengths to which courts, Congress, the Justice Department, civil rights groups, politicians, and academics have gone in their attempts to rationalize today's egregious racial politics, in which plainly partisan disputes are transformed into inflammatory racial conflicts. Things have gotten so absurd that in recent cases Leftist groups have tried to argue that virtually any Democrat—whether a minority or not—elected with black or Hispanic support should be protected by the VRA. In 2006, advocacy groups tried to argue that Martin Frost, a prominent white Democrat from Texas, should be protected as a minority candidate of choice under the Act. Although Democrats lost that one, Republican legislators rewarded them by voting in droves for the 2006 Voting Rights Act—once again demonstrating their stupidity and pusillanimity on race issues—which will likely give the Democrats exactly the outcome they sought in the Frost case. Thernstrom calls the new legislation "a Democratic Party dream" because if minorities do reliably vote Democratic, "all districts in which they played a role in electing Democrats (white or black) would likely be considered sacrosanct." The key provisions of the new VRA will not expire until 2031.

Examples such as that one lead me to think that you're right, Joel, but for the wrong reason. Health care reform may or may not be a "worthy cause" -- it's difficult to know just how this particular bill accomplish the "worthy" goals you outline. We won't know the true size and scope of the legislation for years. Don't forget, although the tax increases are immediate, the benefits won't take effect for five years. Most of the regulations won't be written for at least a year, assuming this bill survives multiple constitutional challenges in the federal courts.

But the point is, once the deed is done, it's very difficult to undo. Ronald Reagan could not undo the New Deal or the Great Society, after all -- he couldn't even shut down the Department of Education. Centralization exerts a powerful pull that few politicians, seduced by the blandishments of position, can easily resist for long.

& the Best News about the HC Bill Is...

... that millions who can't afford healthcare will get some sort of opportunity for some sort of coverage at the behest of some sort of federal urging, millions more will not have their insurance revoked if it needs to be used for catastrophic illnesses beyond the sort my family has been through [our insurance has yet to be canceled due to illness(es)], and there is absolutely no downside to this at all, if I am listening to the promoters of the bill correctly.

How can anyone object to this sensible piece of well-focused and precisely-drawn legislation?

"There's a reason we don't quote Hitler when we discuss highway spending. It just puts too much noise into your signal." Joel, 2010

"Absolutely no downside"

Won't claim that. Nor will I claim it's "precisely drawn" legislation. Health care reform -- like all human endeavors, and especially like all legislative endeavors -- undoubtedly has flaws.

I'm saying the good mostly likely vastly outweighs the bad - from my perspective. And the bad, when it rears its ugly head, can and will be fixed in future legislation.

Fixed?

No, Joel, it won't be fixed. Because fixing it will entail reducing promised benefits or raising taxes beyond what's already in the bill. And we all know how much stomach lawmakers have to do either. (Steny Hoyer, hours before the first vote, was already ridiculing Republican talk of repeal as "taking away your benefits.")

Unless this thing is tossed out in court, it's my sincere belief that the United States as a dynamic, entrepreneurial beacon of hope will soon be a distant memory. It'll be impossible to ever roll back this entitlement. And because the Boomers were on the verge of bankrupting the nation before we got Obamacare, this new bill will only hasten our demise.

But hey, at least my kids won't have to survive this debacle, cuz I don't have any. There is that ...

RE "Fixed?"

"No, Joel, it won't be fixed."
You guys can't have it both ways. Either the "vast majority" (read: 48.8%) of the public is against this and with empower the Republicans with the political will to repeal it, or people will realize that it's good to have reliable health care for everyone, and we won't need to "fix" it.

"Reliable health care for everyone"

If that's anywhere in this legislation, I'd sure love to see it.

RE Reliable Health care

Well, the proof will be in the pudding to be sure. No one knows how this will ultimately play out yet. It could be that the insurance lobby will figure out a way to pervert the intended consumer safeguards. They will certainly try, and they will probably ride the Tea Party wave to get there. But for one thing, we no longer face the prospect of being denied coverage for pre-existing conditions, so in that sense we can "rely" on our coverage.

One more, then I'll leave it

From Reason's Peter Suderman:

It's being hailed as a major legislative achievement, and in size and scope, it certainly is. But for those of us who do not take comfort in legislation of great size and scope, it's an achievement of dubious merit.

But it's not just the size and scope. It's also that this bill is unlikely to achieve most of the objectives that have been set out for it.

The retail argument in favor of the bill was basically twofold: It provides affordable insurance coverage for 30 million, and it reduces the deficit, thereby making it fiscally sensible.

But CBO is clear: In conjunction with the upcoming doc fix—which was split off from the original bill and will be passed later—it doesn't lower the deficit. And if Medicare savings are used to extend the solvency of the program, as Democrats frequently claim will happen, then that eats up the deficit reduction.

The coverage figure is the best argument for the bill; all indications are that it's likely to result in health coverage for 30 million or more individuals. But the evidence that it will do so in an affordable manner is thin. The CBO estimates that the average premium cost will rise 10-13 percent (with a little more than half of folks receiving subsidies). And despite claims that the bill will put a stop to big rate increases, the evidence of the Massachusetts plan, which is very similar to Obamacare, suggests otherwise: Since the start of its plan, that state has seen double digit rate hikes, and expects more to come. And its average premium price is the highest in the nation. How can anyone possibly define this as "affordable"?

In the end, then, we're left with a highly expensive, fiscally dangerous expansion of health insurance that locks even more people into a broken system. That's an achievement, all right, but not a particularly good one.

Links embedded in the original, so for the backup info, read the whole thing.

HuffPo: My Favorite HC Reform Commentary So Far,

has this to say, breathlessly, about the "TOP 18 immediate effects" of this well-crafted, scopey, sizable law(s):

WHAT YOU NEED TO KNOW!

Coming in at the NUMBER 11 IMMEDIATE EFFECT:

Indoor Tanning Services Tax

"This tax will impose a ten percent tax on indoor tanning services..."

http://www.huffingtonpost.com/2010/03/21/health-care-bill-passes-l_n_507...

"...Fixed"

That'll do, Joel. I (truly) look forward to the intelligent supporters of the bill and its labyrinthine depths to responsibly & properly shepherd future legislators to effect the changes needed.

No doubt the "nay-sayers" like myself will be on board with trying to steer the behemoth, but that goes without saying, and we will need some supporters alongside to keep the whole thing in balance.

Too bad we can't just come up with 100 pages or so of targeted law that does some precise version of "good," aimed at a precise problem.

I guess those days are past us forever.

"There's a reason we don't quote Hitler when we discuss highway spending. It just puts too much noise into your signal." Joel, 2010

Memories

The Civil Rights legislation passed with bi-partisan support:

The House vote was 289 to 124.
80% of the Republicans voted for it.
63% of the democrats voted for it.

The Senate vote was 73 to 27.
The No votes were 21 DNC, and 6 GOP.