Thursday, December 18, 2008

How to lose the health care debate

Yesterday, I spoke with someone who allegedly worked for someone important in the failed 1993-1994 campaign for health care reform spearheaded by Hillary Clinton. He was obviously very knowledgeable, and since I very much would like universal health care guaranteed by the government, I expressed to him some of my concerns about putting a universal health care plan in practice. (I do not quote exactly, but paraphrase the conversation.)

--Might there not be constitutional difficulties?

--Well, people really want health care. It's time has come and they're fed up with it. I think they're ready for the government to act.

--But if someone takes the health care plan to court and it goes all the way to the Supreme Court, will the court dismantle such a program as unconstitutional?

--In that case, the countersuit will point out that the financial system shouldn't be bailed out.

--But wouldn't a protest against the financial bailout be a separate case and not part of a countersuit?

--Well, I think there are enough precedents to justify the constitutionality of the program.

I didn't bother to ask this very knowledgeable person what those precedents were. Not being a lawyer, I don't know, but I seem to recall that constitutional concerns have shaped (and limited) the way Medicare and Medicaid were implemented. I also wonder whether the Court's New Deal precedents would stand in the face of an ambitious new program. I'm not convinced that most of the "liberals" on the court--let alone the "conservatives" (again, I think the split is more partisan than ideological)--would be comfortable with such an expansion of governmental power. Each wing's constituency, I believe, is centered on non-economic issues (although I suppose the Kelo decision might tend to contradict me). I also didn't bother to mention that even though he and I could very well find precedents to support a universal health care plan, those might not be the same precedents followed by the court, especially since neither of us is a lawyer who has good knowledge of what will pass muster.

The conversation continued, with my very knowledgeable acquaintance making a variety of arguments that tend to be strongest when used with someone who already agrees with you, including a reference to the "genius" of Michael Moore's movie "Sicko."

This is how to lose the health care debate: assume that the people who disagree with you are idiots; assume that anyone who raises sincere questions (questions which arise from a sincere desire to see a plan passed that will not be dismantled by the Courts in 5 or 10 years) is a contrarian who's not looking for an honest answer.

Maybe I'm wrong. Maybe the way to win the passage of programs one likes is to insult the people whose support you might need in order to rally the support of people who are already on your side but might sit the fight out. It seemed to work for Karl Rove and his strategy of playing to the Republican base. So, I'm not completely against my very knowledgeable acquaintance's strategy.

Still, I'd much rather speak with an opponent of health care reform who will treat with respect people he disagrees with rather than speak with a very knowledgeable person who will just give me 14-year-old talking points.

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