Interesting reactions from left and right to the passage in the House of health care reform.
A bill nobody has read, that contains nobody knows what, that no one has a clue of what kind of impact it will have on the current health care system, with a cost known only to God, has been passed with no formal hearings, extraordinarily limited debate, and in a totally partisan manner (minus one Republican who doesn’t have a prayer in 2010).
That’s the “reality” I would say to my friends in the reality based community. Can you argue with any of those points above? Only if you spin so hard you are in danger of flying off into orbit.
If we had a rational government, any one of those realities would have derailed health care reform long ago. But rationality has left the building, as has common sense, proportionality, wisdom, and that fine old conservative virtue, prudence.
National Health Care Reform represents a new way of governing; the blind, leading the deaf and dumb, toward an unknowable future - driving the engine of government at full speed, and without any brakes. Can’t see that break in the tracks up ahead? Ooops! My bad. We’ll pick up the pieces later.
Of course, this is only the first step. Something approximating the House bill is going to have to pass the senate - by no means a foregone conclusion, but made more likely by last night’s vote. And the conference committee to reconcile the two versions while hanging on to enough votes in both houses for passage will be something akin to trying to put a round peg in a fractal hole.
But the momentum appears to favor getting something passed before the end of the year. If the House vote proved anything, it is that the Democrats are fully capable of coming up with solutions that will allow their huge majorities to win the day regardless of the issues. They have proven adept at papering over their differences, finessing the insoluble, and coming up with imaginative gimmicks to make national health care reform a reality.
The question then arises; where to, conservatism?
There has been more than one liberal pundit who has speculated that the passage of national health care reform would mean the death of conservatism. Holy Jesus! If communism couldn’t be killed by it’s massive internal contradictions, I hardly think conservatism is in any danger of going the way of the Dodo bird because national health insurance has become a reality.
But perhaps the chocks will be pulled out from underneath the kind of “small government” conservatism that believes rolling back the Great Society, the New Deal, and taking America back to a fiercely literal interpretation of the Constitution, is the path that conservatism should follow.
I put “small government” in quotes because the reality is that most who adhere to that brand of conservatism are actually proponents of “no government” conservatism. All conservatives look in askance at the welfare state. But there is a difference in seeking to destroy it willy nilly and substitute a pre-Constitutional environment more in keeping with the Articles of Confederation, than in drastically reforming both the programs and ideology that undergirds the culture of dependency that has taken control of government. But the “no government” conservatives will become even more irrelevant now that we are on the road to nationalized health care. Government as the “enemy” may still be a potent call to arms for these conservatives, but their impact on actual public policy will be close to zero.
If national health care becomes a reality, history tells us that it will never be repealed, that one sixth of the American economy will be permanently controlled by Washington. There will be successful efforts to play around at the margins, bringing efficiencies and changing some of the more odorous aspects of what is to come. But politicians have never taken away an entitlement in history, and I am extremely skeptical that it can be done in this case.
Once the independent health insurance industry is gone, how to you get it back? How do you reconstitute a private health care system? The answer is you can’t. Once national health care has had its way with the system and we see single payer insurance, and a health care bureaucracy that dictates treatments, costs, eligibility, as well as rationing what care is left, it will be impossible to ditch that system in favor of a market based, private entity. It is much easier for government to destroy private industry than it is for government to actually create a free market for health care. The very act of government creation would, by definition, not allow the market to determine the parameters of its operation.
So, do conservatives deal with this reality and work to affect it, or do they cling to the irrational belief that they can turn the world upside down, repeal a middle class entitlement, and resurrect an entire industry? I believe that, along with other entitlements, conservative principles can be applied to governance so that it’s costs are kept from rising too quickly, while choices can be broadened. In short, if there must be national health care, conservatives can run it far better than liberals.
Not very satisfactory but real world options are rarely as palatable as those we imagine when clinging to dreams of Jeffersonian (or Randian) utopias. John Galt may be a folk hero, but even he is going to need to see a doctor at some point. So, from where I’m sitting, (given the strong probability that national health care will be a reality by the end of the year) you can either work to radically improve what the Democrats have so carelessly tossed into the people’s laps, or you can continue thinking that it is possible to create a government that doesn’t do much except kill terrorists and give out tax break like pieces of candy corn on Halloween night.
That’s an exaggeration, of course. But my purpose - groping, feeling my way in the dark though it seems - is to think about what conservatism means facing this new reality. Those who wish to continue living in a fantasy world where “no government” or “small government” (rather than “smaller government”) dominates, I congratulate you on your efforts. It is more than the rest of us who wish to advance the cause of conservatism in the real world are capable.