As the health care reform debate intensified, one strain of objection has centered on the "undue" speed and sloppiness of the reform effort. We should slow down and get it right, opponents argue.
Only we have been trying to get it right for decades and meanwhile the problems have only gotten worse. But they are right in saying the current legislative vehicles have enormous flaws and likely will not perform as advertised.
Yeah, right - like any government program does.
So the choice is between ugly choices or none. I go with ugly, and so does John Cassidy.
So what does it all add up to? The U.S. government is making a costly and open-ended commitment to help provide health coverage for the vast majority of its citizens. I support this commitment, and I think the federal government’s spending priorities should be altered to make it happen. But let’s not pretend that it isn’t a big deal, or that it will be self-financing, or that it will work out exactly as planned. It won’t.
Many Democratic insiders know all this, or most of it. What is really unfolding, I suspect, is the scenario that many conservatives feared. The Obama Administration, like the Bush Administration before it (and many other Administrations before that) is creating a new entitlement program, which, once established, will be virtually impossible to rescind. At some point in the future, the fiscal consequences of the reform will have to be dealt with in a more meaningful way, but by then the principle of (near) universal coverage will be well established. Even a twenty-first-century Ronald Reagan will have great difficult overturning it.
That takes me back to where I began. Both in terms of the political calculus of the Democratic Party, and in terms of making the United States a more equitable society, expanding health-care coverage now and worrying later about its long-term consequences is an eminently defensible strategy. Putting on my amateur historian’s cap, I might even claim that some subterfuge is historically necessary to get great reforms enacted. But as an economics reporter and commentator, I feel obliged to put on my green eyeshade and count the dollars. [More]
We have used this act-first-and-figure-out-the-consequences-later practice as standard procedure for most of my adult life. Our Iran policy springs to mind as an example. Congress - and the American polity, for that matter - have never produced brilliant legislative action as a result of careful study and reasonable debate. Farmers ought to know that from many farm Bill experiences.
Perfection is the enemy of the possible, and I would sooner push the system to where, as in other developed countries, no American worries about getting basic health care, going broke because of a health problem, or losing health coverage when laid off. We'll figure out how to pay for it and control costs when the economics absolutely force us to.
This is how we do other less important programs, and how we arrange the economic crises that will allow for politically unpopular entitlement reform.