Some commentators, such as Sean Trende writing for Real Clear Politics, have likened the Democratic fixation on health care reform to Captain Ahabs obsession with Moby-Dick. He ended up catching the whale, but, as Trende says, we all know what happened next.
There is much to be said for this maritime analogy, including the way Barack Obama, Nancy Pelosi, and Harry Reid are proceeding with reckless lack of concern about the consequences to themselves and, much more importantly, the crew (that is to say, us).
I would nevertheless like to offer my own maritime analogy for the health care fiasco that is brewing in Washington. For the first time in my life, I feel like a passenger on the Titanic. The nation, which a mere ten years ago felt itself unsinkable, is headed toward an iceberg that could capsize her, both financially and politically. Though it is not unavoidableand might yet be avoided if only one Senate Democrat steps up to the challengeit looms near.
Financially, we are already facing tens of trillions of dollars in unfunded liabilities from existing entitlement programs. Medicare is projected to run out of money in less than a decade. The Democratic health care program, in whatever incarnation it emerges from the super-duper secret negotiations among that broadly representative trio of Obama, Pelosi, and Reid, will be built around a giant new health care entitlement. (If we are lucky, Pelosi will forget the password and secret handshake required to gain entrance. Then again, she will probably be able to sneak in anyway.) Democrats are not just rearranging the deck chairs on the Titanic, they are congratulating themselves for taking on new passengers.
Claims that the program is “paid for” and will even end up reducing the federal deficit are pure fantasy. No entitlement program has ever failed to cost much more than projected. On the other side of the ledger, many of the assumed savings will doubtless fail to materialize. If the half-trillion dollars in Medicare cuts do miraculously come about, they will be applied to Obamacare, making them unavailable where they are really neededto save Medicare itself. To make the ten-year budget projections come close to balancing, Democrats have arranged the program so that revenue begins coming in immediately but spending does not phase in until the fourth year. Once we move past that milestone, the program bleeds dollars. In short order, we will be faced with a choice between crippling and unsustainable debt and crippling and unsustainable taxation. At some point, China may lose interest in financing Ahabs obsession. If it does not, we will become more and more beholden to Beijing. Either way, we lose. Historians may look back someday and conclude that Obamacare was the final nail in the coffin of American economic leadership in the world.
Politically, the United States has always been a special country, motivated by a powerful political idea. That idea emphasized limited and relatively decentralized government, a relatively high degree of individual liberty and responsibility, and the priority of opportunity over guaranteed results. This idea has made America one of the freest, most prosperous, and most innovative nations on earth, and a magnet for the ambitious and the dispossessed of the world. Of course, this model has been undermined by the Progressives, the New Deal, and the Great Society, but it has retained no small part of its substance and its appeal, especially in comparison with the rest of the world. If it passes in anything like its current form, Obamacare will change the political center of gravity, representing a dramatic breakthrough for unlimited and centralized government, collectivism, and redistributionism. The new entitlement and the taxes necessary to sustain it will have more than an economic effect; they will have the political effect of making America that much less of a free country and that much closer to Tocquevilles democratic despotism, in which government treats the people not like free citizens but like a flock of timid but industrious animals, of which government is the shepherd. To convert America into Sweden has long been a dream of the American left. Obamacare will be a big, though incomplete, step in that direction, and it is a step calculated to make completion of the journey all but inevitable.
Thus, Obamacare has the potential to deal a heavy blow to our prosperity and our liberty all at once. And this does not count the other costs in life and health that will be incurred by the government regimentation of health carethe rationing and regulation, the mandates on individuals and businesses, the disincentives to innovation, and the increasing cost of insurance that will almost certainly ensue.
If the potential damage to the Ship of State is metaphorically comparable to that suffered by the Titanic, another parallel is that no one can count on the damage being reparable, even if (as seems increasingly likely) Democrats suffer a major setback in the 2010 elections. Passage in the Senate is going to require 60 votes; so is retrenchment. Even if Republicans do extremely well in 2010 and 2012, it is almost inconceivable that they will amass 60 votes in the Senate. A number of Democrats will have to join them.
The record of entitlement programs being repealed is very thin, though opponents can gain some encouragement by noting the Catastrophic Health Care program, which was passed in 1988 and repealed in 1989 after a vigorous public outcry. There will be a window of three or four years during which (in order to satisfy the Democrats fiscal legerdemain) people will be paying the cost of the program without receiving the benefits. If it is not repealed or dramatically changed during that window, the odds are high that it is not going to be. Of course, we will spend the next half century fighting over the program, all the harder because millions of Americans will not accept its legitimacy after their putative representatives force it down their unwilling throats. Given the stakes, it will be a battle worth fighting. All the same, after the side of the Titanic was ripped open and the mighty ship tumbled through the dark waters to its resting place, it has remained on the bottom. Indeed, it took decades for anyone to even find it.
It is not a perfect analogy. The Titanic hit the iceberg by accident, due to arrogance and carelessness. In our case, arrogance and carelessness are driving the Captain and his mates to steer for the iceberg deliberately.
Andrew E. Busch is an Adjunct Fellow of the Ashbrook Center, Professor of Government at Claremont McKenna College, and Ann and Herbert W. Vaughan Visiting Fellow at the James Madison Program in American Ideals and Institutions at Princeton University.