Seamanship Quotation

“In political activity, then, men sail a boundless and bottomless sea; there is neither harbour for shelter nor floor for anchorage, neither starting-place nor appointed destination.”
— from Michael Oakeshott's
Political Education” (1951)

Wednesday, June 27, 2012

Obama Care Decision: Silver linings in tomorrow’s clouds?

It’s just too tempting to say something optimistic when conventional opinion can’t find anything positive to say. The prospect of the US Supreme Court—nine lawyers—determining the fate of the biggest health care reform in US history, and quite possibly the fate of the incumbent president, is irresistible.

Two positive propositions have emerged: the political center will get more concerned about the extraordinary powers of the court, and Democrats will again get more radical about fundamental health care reform.

On judicial reform, Ross Douthat well expresses the vision of a possible consensus in his column “The Liberal Embrace of Judicial Restraint.”

“But one can disagree with the specifics of the liberal brief against the Roberts Court and still welcome liberalism’s conversion to the cause of judicial restraint. It should be a point of bipartisan consensus that the judiciary is a political body rather than a panel of Platonic Guardians, and it’s a healthy thing for our democracy to have the other branches of government ready to push back when the high court seems to overreach. This pushback can and should include the possibility of reforming the way the court does business: Term limits and supermajority requirements, for instance, are both plausible responses to the weirdness of having our great controversies settled by the timing of an aging justice’s final illness, or the idiosyncrasies of Anthony Kennedy.”

On health care reform, former Chair of the National Democratic Party Howard Dean sees the possible elimination of “individual mandates”—the centerpiece of Obama’s universal private insurance model—as the last best chance to get the single-payer model back into the Democrat’s platform.

Both propositions rely on a more sympathetic political climate in the country and, in particular, in the US congress. The former, however, does have potential appeal to Republicans, independents, and Democrats. The later has no prospect of success without a decisive take-over of the Democratic Party and, then, the US Congress by old-style New-Deal liberals.

Howard Dean may not “give a damn” about Obama’s liberal-conservative health insurance compromise. However, he doesn’t offer any credible way to get a better reform out of a disaster for Obama in the court.

To replace Obama-Romneycare with a nationalized single-payer insurance scheme would require the financial surpluses of Bill Clinton, the left illusions of the 30s, and Lyndon Johnson’s 1964 electoral sweep—with conservatism in disrepute and without such “distractions” as the civil rights movement and the War in Vietnam.

There have been 15 presidential elections and 30 congressional elections since Harry Truman first proposed universal health insurance.

Only Obama’s plan—with its universal consumer mandate—has made it into law. It is the product of trial and error, liberal and conservative economic, health and management ideas. The mandate isn’t “arbitrary.” Broccoli won’t be next. It’s the only instrument 60 years of discussion and votes have found to realize a massively popular idea—assured and reasonably equal access to the full range of essential health services.

The Canadian federation to the north doesn’t have a national single-payer system. Mr. Dean’s federation is 10 times bigger and its national government is extremely unlikely to create one either.

If the Supreme Court throws out the mandate tomorrow, the only alternative for reformers is to propose a significant, broad-based health insurance tax. That will not be realized in the next four years, whoever wins in November. 

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