Balkinization: Why it's fallacious to compare the stimulus bill to, say, reforming the medical care system

Why it's fallacious to compare the stimulus bill to, say, reforming the medical care system

Sandy Levinson

It is obviously tempting to assert that the quick passage of the stimulus bill (after paying tribute to the unholy threesome of Collins, Snowe, and Specter) adequately disproves my reiterated argument that we have a system that makes it difficult, if not impossible, to confront adequately the challenges that face us, such as getting a handle on our inefficient and unjust system of delivering medical care to those who need it. My view is that it is a big mistake to take much comfort in the quick passage of the stimulus bill (putting to one side whether one approves of everything that was in it, a discussion I have no desire to get into). In many ways, it was an "easy" bill to pass, for at least a number of reasons: a) (almost) everyone recognizes that there is a crisis and that something needs to be done, and fast; b) although the bill no doubt has a lot of consequences, both for good and for ill, in creating incentives for a variety of behaviors, it does not in itself constitute a serious attempt to significantly reform of any important aspect of the American political or economic system; and c) as critics of the bill point out endlessly, it's quite easy to get legislators to vote for programs that shovel money to their constituents and place the burden of paying for the programs on future generations.

So contrast this with reform of the medical system (let alone energy and education, the other two big-ticket items on Obama's agenda). I happen to think our present medical system is part of our "crisis," but I doubt that that is a sufficiently widely-shared reaction. Far more to the point is that any significant change of our present system will require taking on a lot of entrenched interests, beginning with insurance companies, who will do everything they can to retain their share of a lucrative pie. (Just as Obama is unable to accept the increasingly across-the-political- spectrum advice from professional economists to nationalize failing banks, he will, I suspect, be equally unable to support the most rational reform, which is some form of a "single payer" system that gets rid of insurance companies entirely.) And, of course, it may be necessary to raise taxes in order to save Medicare. All of these features make it ever harder to achieve the kind of "complete consensus" between the House and Senate that is a predicate condition for the passage of legislation, especially when one of these two houses ridiculously overrepresents small states and, perhaps more seriously at least in this case--it may be that the issue of medical care is sufficiently universal not to be all that relevant to the large state-small state divided--the ability of a tyrannical minority to prevent bills even from coming to the floor if they can hold their 41-senator coalition together.

I don't disagree with those who say that the Congress should engage in extended deliberation and vigorous debate about the proposed programs. I'm not an advocate of the behavior during FDR's 100 days where the Congress simply passed, without any deliberation, bills they received from the White House. The question is whether a minority in an already undemocraticly constituted Senate should be able to prevent electoral majorities from passing what most Americans believe is desirable, even necessary, legislation.

In more ways than imagined, the next several years will present the most profound test since 1860 of the capacity of our political system to respond to the deep exigencies of the day. I skip the New Deal because, obviously, FDR really didn't have to worry about Republican recalcitrance. He did have to worry about the Supreme Court, whose edict he was prepared to defy had they struck down repudiation of the Gold Clause, but he never had to face that.

Posted 5:47 PM by Sandy Levinson [link]

Comments:

As I understand the proposals, it wouldn't be necessary to save Medicare at all if we get a universal health care system.

# posted by

Mark Field : 6:46 PM

MarkF: I agree, but I think Prof L was suggesting that we will not[easily] get UHC. Thus, we will end up piddling about, doing things like trying to save Medicare for the short term, and that this will make moving forward even more difficult (by giving the naysayers immediate targets).

# posted by

CTS : 8:39 PM

So if we want universal health care all we need to do is (1) dissolve the union, since the current one requires that states be equally represented in the Senate, (2) set up a new constitution, with a unicameral legislature selected on the basis of a national popular vote, and (3) replace the president, since the current one promised that he would not support UHC.

Seems like a small price to pay for a health care system as cost-effective as the one we have for public education.

# posted by

mls : 10:07 PM

"unjust" medical system? As in, there is a heretofore unidentified 9th Amend. right to "just" medical care, or we find it perhaps in the 14th Amend.? What makes medical care "just?" Is it as simple as being affordable for all? If so, when this gets fixed would you next work on winning us "just" automobile ownership because I desperately need an original Porsche 959 to make my life worth living.

# posted by

Redlands : 11:19 PM

"beginning with insurance companies, who will do everything they can to retain their share of a lucrative pie."

As opposed to the government doing all it can to increase it's share of a lucrative pie? Which is somehow always just peachy?

Try to think of the government as just another business, except it's one that can get away with shooting people who don't want to buy it's products. It would clarify your thinking a bit.

# posted by

Brett : 7:03 AM

Oooh. Some of us seem a bit touchy on this issue. I'm thinking we don't need "justice" as a rationale for it; the whinging of conservatives for the next 70 years will be satisfaction enough.

# posted by

Mark Field : 10:22 AM

Brett/Redlands:

What is scary in not Sandy's opinion that nationalizing the health care industry is somehow "just." Everyone is entitled to an opinion.

What scares the hell out of me is Sandy's belief that our current Dem House somehow represents a democratic ideal. I am afraid we are in for a repeat of the Porkulus enactment where nationalization of our health care is written in secret by the Dem congressional leadership without debate or hearings ala the Politboro, disclosed at midnight before the vote and enacted by a Dem majority in Congress who has not even read the bill out of party loyalty ala the Supreme Soviet.

# posted by

Bart DePalma : 10:35 AM

thanks for opening comments prof. levinson ..

and for those who don't like democracy in action.. i.e. .. a constitutionally elected majority expressing the will of the electorate which brung 'em .. y'all are free to emigrate to any other country which has a political system which suits you better ..

# posted by

Jkat : 10:46 AM

Jkat said...

and for those who don't like democracy in action.. i.e. .. a constitutionally elected majority expressing the will of the electorate which brung 'em ..

:::chuckle:::

What will of the electorate?

When McCain argued during the debates that Obama planned over a Trillion dollars in new spending, Obama assured the voters that he would pay for any new spending by cutting prior spending. Now, Obama is projecting a $1.75 Trillion deficit (which is actually an over $2 Trillion) to pay for his massive new spending.

Obama promised to give the electorate time to review his legislation. Instead, Obama's Porkulus bill was written in secret and disclosed on the midnight before the vote.

Obama promised that he would not raise taxes on 95% of the citizenry and more specifically would not use his proposed carbon cap and trade system as a tax increase. Instead, Obama has increased taxes on smokers to pay for SCHIP and has proposed a massive new carbon tax on business through his cap and trade system that will be passed onto all of us in sharply higher electric bills and costs for nearly all goods and services.

When McCain proposed in the debate to have those of us who pay our mortgages bailout those who cannot or do not want to pay their mortgages, Obama wisely said he opposed the plan as did most voters. Now, Obama is proposing the same bailout he campaigned against.

In short, there is very little about this current taxing, borrowing and spending spree that represents the will of the electorate. That is why they draft their bills in secret.

# posted by

Bart DePalma : 11:26 AM

read the recent gallup polls bart .. they very clearly quash your line of reasoning ..

there's a reason we call it "majority rule" ..

# posted by

Jkat : 12:02 PM

Baghdad, so sorry to hear that you don't like our system of government. Perhaps you should move to Iraq. I hear they are now the envy of the Middle East.

# posted by

Bartbuster : 12:08 PM

jkat:

You may recall this Obama promise made repeatedly during the debates that he would cut more old spending than he would impose in new spending for a net spending cut even though he could never name a single program he was willing to cut.

We conservatives laughed and warned the voters that he was lying through his teeth. Unfortunately, the voters did not listen.

Now, Obama proposes the largest spending increase in the history of the Republic both absolutely and as a percentage increase.

Feel free to attempt to argue that this insanity is somehow justified fiscally or ethically, but do not even begin to claim that this was the will of the voters based upon the Obama campaign promises.

# posted by

Bart DePalma : 12:31 PM

jkat:

There is not majority support for the Porkulus bill or bailing out deadbeats who will not pay their mortgages.

A majority of voters also want tax cuts rather than government spending.

Finally, Obama's personal popularity is at the same level with higher negatives than Dubya at the same point in his presidency.

# posted by

Bart DePalma : 12:42 PM

Lot of RECENT polls not looking good for
Baghdad Bart

# posted by

Bartbuster : 1:47 PM

Finally, Obama's personal popularity is at the same level with higher negatives than Dubya at the same point in his presidency.

# posted by Bart DePalma : 12:42 PM

I'm mildly curious why you think this is even slightly relevant?

# posted by

Bartbuster : 2:25 PM

It's very simple, Bart:

(1) Everyone hates government spending in a theoretical, abstract sort of way.

(2) Everyone makes an exception for their own personal program. That isn't spending, it's a service.

(3) Almost everyone loves their own program more than they hate government spending in the abstract. I will conceded there are a few exceptions in the hardcore Republican base who are willing to accept being on the cutting block for spending reductions. But such people are very much the exception and not the rule.

The overall result is that the general pressure on both parties will be to spend more, especially on their own costituencies. The concrete benefit people get from spending will outweigh their abstract opposition to the amount. (And if you don't believe me, consider what happened when Ronald Reagan so much as hinted at cutting Social Security).

# posted by

Essayist-Laywer : 2:46 PM

I should also add that I fully agree with Prof. Levinson. Handing out goodies does not call for taking on any powerful interest groups.

# posted by

Essayist-Laywer : 2:48 PM

EL:

I agree that there is a general upward pressure to spend, so long as there is not a price to be paid for the spending. If everyone's taxes went up every time spending went up, this pressure abates and only important general government services would be enacted.

That is why Obama is financing his various unpopular redistributions to minority (numerical not racial) Dem interest groups by borrowing to pass the taxes to future generations, only openly taxing a tiny minority and seeking to tax the rest of us indirectly through a carbon tax.

# posted by

Bart DePalma : 3:02 PM

his various unpopular redistributions

Baghdad, the stimulus bill has popular support.

# posted by

Bartbuster : 3:18 PM

Bart, Bush was elected without a majority (or even a plurality, as Gore won the popular vote) and proposed all sorts of things that the Congress passed in 2001, including huge tax cuts. Did you argue then that these things lacked democratic legitimacy because a majority of voters voted for Gore?

By the way, in saying this, I should note that I agree with Republicans that they aren't obligated to vote for Obama's programs that they disagree with or even not to filibuster them simply because they lost the election.

The point is, we have the process we have, perhaps we should have a different one, but I don't blame anyone for exploiting the distribution of powers in the current system to enact the policies they approve of or to prevent the enactment of policies they don't approve of. And that goes for Obama, Bush, the Congressional Republicans, and the Congressional Democrats.

What I will say, however, is that the real danger for Republicans is that if the stimulus bill and other Obama agenda items remain popular in 2010 and 2012, Republicans will indeed pay a price for opposing them. (On the other hand, if Republicans convince the public by then that they were bad ideas, they will reap a political benefit.)

# posted by

Dilan : 5:08 PM

"(On the other hand, if Republicans convince the public by then that they were bad ideas, they will reap a political benefit.)"

That may be true. But would the Republicans do any better than they did during Bush's 8 years? With tax cuts? With less government? With perhaps another war? As ye sow, so shall ye reap. Republicans haven't been sowing too well for a long time.

# posted by

Shag from Brookline : 5:23 PM

Dilan:

The point I made in response to jkat is that there is a difference between political power (controlling the Presidency and Congress) and claiming that you are enacting the will of the People.

The Dems have the political power, but no election mandate or current majority support for the vast majority of the particular items being enacted. Indeed, much of what is being enacted is contrary to the promises Obama made to the voters.

Would Obama have even been elected if the voters had known that they were looking something like a 20% increase in government, a $2 Trillion deficit, a Trillion dollar tax increase over the next ten years (not including the new tobacco tax and as yet unspecified carbon tax) and forcing renters and those who pay their mortgages to pay the mortgages of those who cannot or will not pay their own? I tend to doubt it.

2010 and 2012 will take care of themselves. I would much rather stop as much of this mischief as possible now to preserve the health of the economy than to have the GOP win back power after the economy has been pushed into a Japanese style Lost Decade or (Heaven forbid) a Hoover/FDR level depression and the government pushed towards Peronist Argentina like insolvency.

# posted by

Bart DePalma : 5:58 PM

I would much rather stop as much of this mischief as possible

By doing what? The Dems hold all the cards. You no longer matter.

# posted by

Bartbuster : 6:17 PM

BD: I would much rather stop as much of this mischief as possible

By doing what? The Dems hold all the cards. You no longer matter.

The voters matter if the Blue Dogs hope to get re-elected rather than tossed from conservative districts as they were in 1994.

The businesses matter if the Dems hope to be able to finance 2010 and 2012.

For example, the banks have already started fighting back as Pelosi failed to gather enough Dem votes to ram through cram down legislation allowing bankruptcy judges to order a reduction of home mortgage principles. This is an exceedingly bad idea that will equate with unsecured credit card debt and compel banks to add a substantial risk premium to the interest rates for home loans the way they already do for unsecured loans.

The GOP needs to make public all the details of the upcoming legislation and scream bloody murder if the Dems try another anti-democratic secret legislation stunt like they did with the Porkulus.

# posted by

Bart DePalma : 8:24 PM

The voters matter

The voters support Obama and the stimulus bill.

# posted by

Bartbuster : 9:58 PM

The GOP needs to make public all the details of the upcoming legislation and scream bloody murder if the Dems try another anti-democratic secret legislation stunt like they did with the Porkulus.

Next time you might want to find someone other than Bobby Jindal to do the "screaming".

# posted by

Bartbuster : 10:00 PM

"The voters support Obama and the stimulus bill."

That would be a reasonable statement if he had RUN on anything even vaguely resembling the stimulus bill. Which he didn't. You seem to be operating on the principle that, if the voters elect somebody, they must support everything that somebody subsequently decides to do. That's like saying that I authorized the babysitter to pawn my good silver just because I left her in the house alone.

If the Democratic party is operating on that principle, their next fall will make '94 look mild.

# posted by

Brett : 6:19 AM

You seem to be operating on the principle that, if the voters elect somebody, they must support everything that somebody subsequently decides to do.
# posted by Brett : 6:19 AM

No, I'm operating on the principle that the poll numbers all indicate that the majority of Americans support Obama and the stimulus bill.

# posted by

Bartbuster : 8:46 AM

You seem to be operating on the principle that, if the voters elect somebody, they must support everything that somebody subsequently decides to do.

I don't want to distract from the main conversation, but doesn't every political party operate on that assumption? It hasn't been that long since we were hearing about the "political capital" and "clear mandate" gained in the (much narrower) 2004 election.

# posted by

PMS_CC : 1:21 PM

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# posted by

Unknown : 3:30 PM