Saturday, March 20, 2010

Hubris and health care reform

I haven't written on the health insurance reform since Scott Brown won the race for senator for Massachusetts. At the time, I was almost despondent, but realized that the way in which the reform, which I wanted to pass, was being pushed through by the Democrats made the bill suspect and unpalatable. The bill, of course, is unpalatable in many other ways: it's unclear what, exactly, is in the bill; it appears that it would operate as a huge subsidy to the insurance industry; it might be unconstitutional; it simply might not work.

Supposedly, the House will, tomorrow, vote on the bill using an arcane parliamentary rule that I had never heard of before--the (in)famous "deem and pass" rule--that, if I understand it correctly, would effectively enact the Senate bill approved last December and add amendments which the Senate can accept or reject and then declare "passed" whatever the Senate accepts. This approach to passing the bill has at least two problems, even if one assumes that it is constitutional or won't be invalidated by the Supreme Court:
  1. It will, apparently, enable House members to vote for the bill by voting for the "deem and pass" mechanism, but not vote for it in its entirety. In other words, House members can, at least in theory, avoid responsibility for voting for it, but still take credit if it passes. In principle, this is a bad thing, but in practice, at least in this case, I'm not too bothered. I can't imagine anyone who pays attention to the health insurance reform debate would believe that a vote for "deem and pass" isn't a vote for the bill.
  2. If I understand correctly, the "deem and pass" measure can theoretically enact into law a bill, the complete and full text of which has not been voted on by both houses. Supposedly, "deem and pass" is not a novel approach to legislation, just an unusual one reserved for relatively uncontroversial bills that both houses, and presumably both parties, wish to fast track. Still, in a bill of this magnitude, I am disturbed by the parliamentary gymnastics that the Democrats are indulging in.
I support this particular health insurance reform measure. It might not work at all, but I'm willing to take the gamble. Of course, it is easier for me to arrive at that position because the measure, if it works as advertised, would probably benefit me more than it would a lot of other people and would shift the cost to other people who are not me.

This is one of those public policy issues where I not only understand the point of view of people who disagree with me; I also sympathize with them and believe they may very well be right. People of goodwill can and do disagree with this bill and with the type of comprehensive health care/insurance reform that liberal-leaning people like me support. I believe that most "conservatives" do not in their hearts like the fact that some people are without access to health care and do not like to see people thrown into poverty because they are diagnosed with a life threatening illness, but that they disagree with the statist approach that I and others favor.

In short, I hope the measure passes. If it does pass, I hope it survives the inevitable constitutional challenges and attempts to repeal it. I hope, also, that the bill actually works.

3 comments:

James Hanley said...

"I can't imagine anyone who pays attention to the health insurance reform debate would believe that a vote for "deem and pass" isn't a vote for the bill."

Actually, I've been paying attention, and I remain unpersuaded that the deem and pass method would have been a vote for the bill.

I think I'm relieved that it passed without resorting to such measures (even though I oppose the bill substantively). It's better this way, and avoids the taint of illegitimacy.

On the other hand, because this bill brought the apparently increasingly-common-but-heretofore-unnoticed deem and pass method to public attention, I almost hoped it would pass that way just to galvanize public opposition to the method (not to the bill itself). But disentangling the two in the public's mind was probably too much to ask for, and the health care issue shouldn't be twisted into a purely procedural debate, so it's probably good that this didn't happen.

With any luck, though, the media's now aware of deem and pass and will bring it to our attention next time either party tries to use it.

theolderepublicke said...

Mr. Hanley,

Well, now that I've met someone who's paid attention to the health care debate and believes a vote for the "deem and pass" measure isn't a vote for the bill, I guess I can imagine him :)

I suppose what I meant was that for the purposes of this fall's election, those who would have voted for "deem and pass" could not have hidden behind the fact that they merely had cast a vote for a procedural rule when this procedural rule would have resulted in passage of the bill itself.

Perhaps I had underestimated the ability of congresspersons to do so in an election. I imagine that the "Stupakites," or at least those who voted for the bill, will try to claim that the president's executive order on abortion actually places any substantive changes on funding for abortion. (I'm under the impression that the order was more or less just to provide political cover for those politicians who claimed to be uncomfortable with the bill's abortion language or lack thereof.)

I'm not quite as optimistic as you are that "deem and pass" will be remembered enough for people to challenge it. But who knows?

Thanks for the comment!

James Hanley said...

"for the purposes of this fall's election, those who would have voted for "deem and pass" could not have hidden behind the fact that they merely had cast a vote for a procedural rule"

Ah, now that I agree with 100%.

And for the record, I'm purely imaginary anyway.