Health care reform is in serious trouble. The Congressional Budget Office just came out in opposition to it.
Obama boxed himself into a corner right out of the gate by framing the health care plan as a fiscal reform to save money. Nobody seriously believes that you can create a huge new government entitlement, bring tens of millions of new people under its umbrella, and then somehow manage to save money. Now that the bill has to be specific, that reality is showing up on the bottom line, and that’s scaring a lot of people.
For example, the Blue Dog Democrats are already jumping ship. And this thing hasn’t even gone to the Senate yet. The Senate is a more serious body, generally more centrist than the House, and there’s no way this bill is going to fly.
This was exactly what happened with Hillarycare in the 90’s. Once you get specific, it becomes impossible to be fair to everyone, so Senators and Congressmen who have to answer to their states or districts start backing away.
For example, the current bill extends the medicare payment scheme. Politicians from rural districts or more rural states have a big problem with this, because medicare payments are biased against them (health care costs in the cities are much higher and access to care often better, but rural people have to pay the same amount of money).
Then there’s the surtax on the rich, which isn’t much liked by politicians from states with wealthy populations, because it hobbles their ability to levy their own wealth taxes, and because the cost of living is very high in many of those states, so the ‘rich’ aren’t as rich as people with the same income living in cheaper states.
Then there’s the opposition from politicians in states that are suffering heavy job losses. Their overriding concern is job creation, and new health care mandates on small business will kill jobs (the bill admits this). This bill adds an 8% tax to any businesswhich doesn’t provide health care benefits and which has a payroll over $400,000.
A $400,000 payroll could hit businesses as small as a mom-and-pop grocery with a couple of managers and half a dozen clerks and stockboys. A lot of these businesses run on a shoestring, pay their employees fairly low wages, and have thin margins. They can’t just add 8% to the cost of labor. The likely response is that they will have to cut employment. And because the marginal cost of having the payroll go over $400,000 is so high, there will be a lot of businesses with payrolls close to that which will either cut employment if they are slightly over, or refuse to hire the next worker who would put them over the top. The same is true of pay increases - an increase which puts the payroll over the magic $400K limit is unlikely to take place.
But guess who loves such measures? Wal-Mart and other big retailers, who got on board early and lobbied hard for such measures. Many of them already provide health care benefits, or can provide it cheaper than their smaller rivals because of their larger risk pool and bargaining power with insurance companies. So Democrats who have championed small retailers and railed against the big box stores are in a position were they are helping put the small business competition at a greater disadvantage.
The devil’s in the details, and for something as complex as health care, there are a LOT of details. That necessarily means that any bill that passes will be so rife with compromises and payoffs to ensure votes that it will either collapse under its own weight or be passed and create a disaster.
This problem is not helped by Nancy Pelosi, who is the worst speaker in my memory. Her modus operandi is to get bills passed by simply buying off everyone who objects, regardless of the consequences for the bill itself. She did it with cap and trade, she did it with the stimulus, and she’s doing it with health care. She’s a big part of the reason why almost every bill that’s come out of the House this year has been an incoherent, pork-laden monstrosity that doesn’t come close to achieving the goals set out for it.