Why the Health Care Rush?

Originally Posted At The Wall Street Journal
June 3, 2009

If sharks stop swimming, they sink and drown. President Obama seems to view his health-care program the same way. "If we don't get it done this year," he said in a recent pep talk to supporters, "we're not going to get it done." Well, why? If laying "a new foundation" for 18% of the economy really is as important as the President claims it is, then surely it could withstand more than fleeting inspection.

Instead, Democrats are trying to rush the largest entitlement expansion since LBJ into law with a truncated debate and as little public scrutiny as possible. At this point all they've released are the vaguest "policy options," not concrete specifics. Yet the Senate plans to begin marking up legislation next week, maybe hold a hearing or two, then have something to the floor by the end of the month, votes by the August recess and a bill to the Oval Office by Thanksgiving. On the seventh day, they will rest. Mr. Obama had 24 Senate Democrats over for a White House chat yesterday to drive the calendar ahead.

It's not hard to see why Democrats are trying to hew to this full-speed-ahead timetable. Their health overhaul will run up a 13-figure price tag at a time when spending and deficits are already at epic levels and hook up the middle class to an intravenous drip of government health subsidies for generations to come. These are not realities that Democrats want the American people to mull over for very long.

This is especially true for the majority of Americans who are generally satisfied with their coverage and doctors but worried about cost. They might get scared off if they were allowed the chance to realize that Democrats will do almost nothing to restrain rising health spending. Based on the leaks so far, this year's legislation will hone in on traditional liberal concerns of social equity -- covering the uninsured.

This shell game found its apotheosis yesterday in "The Economic Case for Health Care Reform," from the White House Council of Economic Advisors, which argues that slowing the growth rate of U.S. health costs by 1.5 percentage points would increase real GDP by more than 2% in 2020 and nearly 8% in 2030. But it presents no plan for actually slowing the growth rate of U.S. health costs. Christina Romer's study is a political argument disguised as an economic one in favor of a "reform" that doesn't even exist yet. And in any case, if we're talking about the state of the economy decades hence, why does health care absolutely have to pass this year?

Part of the need for speed comes from the fact that "stakeholders" -- doctors, hospitals, insurers, pharmaceutical and device makers, etc. -- still seem to be experiencing Stockholm Syndrome. Democrats have so far succeeded in conjuring an illusion of political inevitability, which has kept industry groups in line lest they be shut out of the negotiations. But once the policy details of Mr. Obama's new foundation are poured -- above all for a public insurance program run by the government that will run private carriers out of the market and eventually fix medical prices -- even shell-shocked CEOs might stir up their courage to resist. Democrats are of course acutely aware of how industry opposition chewed through HillaryCare in 1994.

The reality is that Democrats are contemplating the most sweeping restructuring of the health markets since Medicare in 1965, and they don't want to let the details slow them down. Or to be more precise, they don't want to let the details let others slow them down. Better to grab what they will portray as a major domestic achievement while President Obama is at the height of his popularity and before anyone understands what it will mean in practice. The consequences and the cost can be explained later.

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