All’s well that ends well, and it’s well enough that the Supreme Court has decided that it’s constitutional for the government to attempt a medical insurance system that covers not just the elderly and the poor but, at last, everyone in between too. With a little luck this principle will be accepted as the contention focuses more on details of implementation.
Of course many Republicans are pledging themselves to repeal the system just enacted, disparaging it as “Obamacare,” but repeal may prove harder as hard-luck cases whose new coverage would be withdrawn come forward to put human faces on the problem. Republicans have only covered themselves with contempt here. Not only have they nothing to offer such hard-luck cases; they have betrayed conservatism to social Darwinism.
Twenty years ago the essence of “Obamacare” — the government requirement that individuals carry medical insurance, with the government purchasing it for those who did not carry it, taxing those who could afford it and subsidizing those who couldn’t — was the conservative plan for national medical insurance. It was proposed by the Heritage Foundation as an alternative to the bureaucratic monstrosity proposed by the Clinton administration. The genius of the Heritage plan was that it covered everyone while preserving a private sector and some choice in medical insurance. Leading Republicans endorsed it, and of course as governor of Massachusetts Mitt Romney got it enacted there.
Now it has become an abomination to conservatives and Republicans, perhaps only because it was enacted by Democrats. Republicans are outraged that the government should require people to carry insurance and tax them for it, as if this hasn’t already been done with Social Security, Medicare, workmen’s compensation, unemployment insurance, and automobiles, and as if people who have no medical insurance are not already taxed for government insurance for others. Such objections are crazy and incoherent, just rabidly partisan.
Maybe the Democrats have not covered themselves with quite as much contempt, but it’s close. Just as the Clinton administration’s overreaching delayed a national insurance system for 20 years, even though the Heritage Foundation’s plan could have been enacted happily back then, the Obama administration and congressional Democrats have failed to defend their creation, leaving the public ignorant about the individual mandate’s many precedents. If the new system will have no defenders, it well could be repealed under a tidal wave of demagoguery.
Then there is the Democrats’ pretense that the new system and the individual mandate don’t constitute taxation, the pretense that Chief Justice John Roberts heroically rejected so that the system might be permitted constitutionally. That pretense was demagoguery too — because Democrats could not bring themselves to tell the country that social insurance benefits cost something. Democrats could have offset the cost issue by economizing elsewhere in government — a couple of stupid imperial wars were always dispensable — but most Democrats cannot sacrifice anything for the greater good.
The public is little better than the political parties here. A Reuters-Ipsos poll on the eve of the Supreme Court decision found most people against the “Obamacare” law and its individual mandate but in favor of most of the law’s provisions, like requiring insurers to cover pre-existing conditions, requiring larger employers to offer insurance to employees, and allowing children to stay on their parents’ policies until age 26. People still take benefits and then resent having to pay.
Maybe the presidential campaign will encourage both sides, and the people themselves, to grow up. The president will be compelled to press the specifics of the legislation and be more of a fighter and less of a smug philosopher-king. Romney will be compelled to explain how he wouldn’t leave hard-luck cases to die in the street or be ruined financially. And while the people may not be compelled to face their own hypocrisy, they may get at least a hint of it.
Chris Powell is managing editor of the Journal Inquirer in Manchester, Conn.