All across the country, Members of Congress are facing very angry constituents over the issue of health care. So ferocious has been the response that an estimated two-thirds of the Members are not even going to hold town hall meetings. Reportedly, our elected representatives are shocked.
I don’t know why. At least a month earlier, my colleagues and I at the National Center for Policy Analysis became aware of their anger as we collected more than 1.1 million signatures on the petition http://www.freeourhealthcarenow.com/ and read all their e-mail responses. Where, you wonder, were the politicians as this anger was boiling over? Don’t they have staffers who answer their telephones and open their mail?
Anyway, a great disconnect has emerged. It may be serious enough to cause the Democrats to lose control of the Congress in the next election. How did this happen? I think there are three causes.
You know you make me want to
Shout…..(come on now)…..
Shout…..(come on now)…..
Shout…..(come on now)…..
1. Politicians who don’t know anything about health care.
As I have written before at this blog, almost no one on Capitol Hill understands health care as a complex system. Not only that, but the left wing of the Democratic Party thinks that the answers are simple. After all, other countries appear to have solved a lot of these problems. Why can’t we just copy what they are doing? Like the Hollywood crowd, these politicians think you do not need to understand complex systems in general or economics in particular in order to have strongly held public policy beliefs. These attitudes served them well (they at least got them elected) until it came time to legislate. At this point, technicians at the Congressional Budget Office (who actually do understand something about complex systems) told them their pipe dreams were pipe dreams. So enter the policy wonks.
2. Policy wonks who do not understand the voters.
Over the past two decades, I have probably participated in several hundred inside-the-Beltway meetings on ways to reform the health care system. One of the almost unquestioned assumptions in all these discussions is that it is right, proper and desirable for the federal government to tell everyone in America what kind of health insurance he/she should have. In fact, most health reform plans are designed so that they won’t work at all if you can’t force people to buy a government-prescribed insurance plan. In these discussions, wonks on the right are almost as bad as wonks on the left. And all are completely out of touch with what ordinary Americans think.
3. A very deceptive presidential campaign.
During the last election, Barack Obama, Hillary Clinton, John Edwards and just about everyone else running for president in the Democratic primary made these promises:
a. Universal coverage (which sounds like helping 47 million Americans
afford to buy health insurance);
b. Paid for by taxes on the rich (which means to most people,
“not me”) and efficiencies gained through preventive care,
electronic medical records, etc. (which sounds like “all gain,
no pain”); and
c. If you like the health plan you’re in (which 87% of Americans
do) you can keep it (which sounds like “we’ll leave you alone”).
Most voters liked these messages. At the same time, they didn’t like what Barack Obama said John McCain would do:
a. Cause millions of Americans to lose their employer coverage
and be thrown into the individual market where premiums
would be unaffordably high and people with pre-existing
conditions would be denied coverage altogether; and
b. If you are lucky enough to keep your employer plan the
federal government would tax you.
[Parenthetical note: That McCain responded so ineptly to all this helped Obama win the (election) battle, but caused so much over-confidence it may now cost him the (policy) war. Indeed, I think President Obama has been truly surprised by the strength of the arguments currently being made against his reform plan.]
Now comes the surprise from Capitol Hill: Forget everything we said during the election. We really didn’t mean it after all. In particular:
a. Whereas the campaign mantra was universal coverage
(“we’re the only developed country that doesn’t insure
all its citizens”), that term is almost never heard any
more. The clear goal now is to nationalize the health care
system (“we’re the only country in the world that doesn’t
have a national system”).
b. Far from being left alone if you like the plan you are in:
1. You and your employer are going to be heavily taxed
if your insurance doesn’t conform to the plan the
federal government is designing.
2. You, along with millions of other Americans, may lose
the plan you like and be pushed into a health insurance
exchange where the premiums are likely to be higher
than what you now pay and health plans have
perverse incentives to underprovide to the seriously
3. Costs cannot be controlled unless we all get less —
fewer tests, fewer exams, fewer services — with
Barack Obama’s grandmother’s hip replacement being
c. Far from escaping the financial burden of reform, it now
appears that everyone will be burdened — from the
elderly to the casual consumers of soda pops.
So, should people be angry? I report. You decide.