Healthcare reform: tyranny of the minority?

            Some fundamental questions about the nature of the democratic process have revealed themselves over the course of the healthcare debate.  For example, how does one reform the system, as President Obama wishes to do, while still telling people that they can maintain the medical and insurance networks that they have now?  Or, why are lawmakers holding town hall meetings now to receive either affirmation or criticism from the public—after the key decisions have already been made?

            Or, why is a group of senators that represents 3 percent of the population crafting 20 percent of the healthcare bill?  That is the question The Washington Post addressed last week in looking at the Gang of Six on the Senate Finance Committee—Max Baucus (Mont.), Charles Grassley (Iowa), Kent Conrad (N.D.), Olympia Snowe (Maine), Jeff Bingaman (N.M.), and Mike Enzi (Wyo.)—who are tasked with finding a way to pay for the new system.  The potential problem is that these folks—while attempting to inject moderation between coastal liberals who yearn for a single-payer system and southern conservatives who seem perfectly satisfied with the status quo—really have the interests of a totally unrepresentative sample of the American public in mind.

         Is this fair?

 

         Let’s have a little history lesson here.  James Madison, who drafted the Virginia Plan prior to the Constitutional Convention as a broad outline of an effective national government, wanted to limit the influence of states on the types of responsibilities that would fall to the federal government in three ways: 1). He wanted the House of Representatives to elect senators (a “dilution” to pick the wise and stable men who would act as a check on the tumultuous lower chamber).  This was scrapped relatively early and relatively unanimously by people who thought that—our republic representing both the people and the states—the state legislatures should be the most appropriate electors of senators.

         2.) He wanted a federal veto on state laws that, by either being bad or volatile or just plain improper, would be overridden by the national government.  He more or less got this, though not explicitly, in the form of the supremacy clause and the fact that federal courts can declare state laws as violating federal statutes.

         3.) Madison wanted proportional representation in both houses of Congress.  This was crucial, and it took him several weeks of vocal opposition to come to terms with the fact that this would not happen.  Small states threatened to walk out and one delegate from Delaware took Madison aside to tell him that if small states could not have their interests represented equally in at least one chamber, they would have to find comfort in foreign hands.  A counter-proposal by the small states called the New Jersey Plan was never seriously considered (even small states recognized that the national government needed to be stronger; consequently the only real difference between the two plans was a unicameral vs. bicameral legislature), but it was leverage the smaller states used to make their concerns heard.

            It’s not that Madison did not respect the concern about a “tyranny of the majority.” He just felt that small states’ fears were misplaced.  He asked, what could Pennsylvania, Massachusetts, and Virginia possibly have in common that would cause them to ally against the smaller states?  In his mind, divisions would be regional—North v. South.  That was where differences in economy, lifestyle, ethnicity, and, of course, slavery would arise.  Naturally, he was correct.

          Fast forwarding one hundred years or so, we can thank the composition of the Senate, for better or for worse, for the shape the nation began to take.  As Manifest Destiny took hold in the 19th century, our continent was still inhabited by the French, Spanish, and British.  What was to keep American settlers loyal as they headed west, far from the seat of the federal government—or any government for that matter?  It was the incentive that they would receive outsize influence in the Senate should they decide to apply for statehood once the population reached a sufficient size.

         The bottom line is that the way the Senate is structured is the same double-edged sword that the Founders anticipated.  Is it fair now?  No.  Was it fair then? No.  Has the Senate augmented its own importance and magnified its own dysfunctions since 1789?  Absolutely.  Is there a fix?  Only if small state senators use their disproportionate power for the greater good—that is to say, they realize that they are the beneficiaries of a two hundred year old compromise and cannot fairly impose the beliefs of a small minority on the majority.

Money and myopia: what’s hurting healthcare reform

            There is nothing un-American about people who are opposed to the healthcare reform legislation.  They have a right to be skeptical about how their current coverage will be affected, what the cost of reform will be, and whether they will still get needed treatment.  I realize that.

            What IS un-American about healthcare opponents is, I believe, summed up in these two sets of video clips.  Here is footage from Sen. Claire McCaskill’s (D-Mo.) town hall today.  These types of events are less about persuading members of Congress or the general public toward a particular direction on the legislation and more about allowing people who feel that they have no other way of being heard to air their opinions to a captive audience.

            But this is not democracy—it’s more state-of-nature than civilization.  Whoever has the loudest voice or the biggest sign is in control.  Yes, everyone has the right to say what they want, but everyone acknowledges that there are limits to how you say things.  People can swear, just not over certain mediums at certain times.  Articles can be written about people, they just cannot be libelous.  And, of course, there is Oliver Wendell Holmes’s famous statement about yelling “fire” in a crowded theater.

            Kudos to Sen. McCaskill for standing her ground, for not walking away, and for not giving up on her constituents.  The worst experience for any customer service representative is being shouted at by a client who is definitely in the wrong.  It doesn’t help that these people are using phrases like “socialism” and “death panels” that trigger a rabid response from the crowd, yet no one fully comprehends what they mean.

            The second un-American aspect of the anti-healthcare crowd is the subject of this video.  Simply put: why can we not provide regular doctor-patient care for all of our citizens at an affordable price?

 

            The answer is money.  Insurance companies and drug companies spend a lot of it to tell us, in essence, how they must continue to make ungodly profits in order for our healthcare to be as good as it is.  It’s a form of blackmail: saying, “You think we take you on a ride now?  Just wait and see how bad it will be once we’re out of the picture.”  And members of Congress apparently see no harm in the correlation between money and influence.  Witness Rep. Loretta Sanchez (D-Calif.) when confronted on the amount of campaign contributions she received from the healthcare industry, morphing her response from “that’s impossible”; to “that’s not a lot” of money; to hey, they should be giving that money to “people who have more direct control” of legislation.

            People can oppose this legislation, President Obama, and vague notions of socialism all they want.  But if money and misinformation are causing people to turn a blind eye to millions of uninsured and underinsured Americans, then this continued resistance to our healthcare crisis is wholly un-American.

Cash for Clunkers extension should be scrapped

         I am in favor of reducing our dependence on fossil fuels.  I believe that carbon emissions from human behavior are warming the planet and will cause drastic climate changes in years to come.  I want our car-centric society to move towards a reliance on public transit and smart growth communities.  I want people to reduce, reuse, and recycle in order to mitigate their footprint on the environment.

         But I am absolutely opposed to the extension of the Cash for Clunkers program.

         On Friday, the House added $2 billion to the program which has run out of money months before its November deadline—after many people doubted whether the original $1 billion would be spent entirely.  The original law was tolerable, in that it provided some economic stimulus, allowed people to purchase more environmentally-friendly cars, and gave hope that the ailing auto industry would somehow benefit from a bump in demand.

         It’s no longer cute anymore.  All this law does is subsidize manufacturers and dealers—one of the most egregious forms of protectionism, in that all states have laws to mandate transactions through dealerships.  In reality, we should be moving toward a “demand-pull” model in which consumers can order their cars directly from the plant, reducing excess inventory and eliminating the middlemen who can take advantage of non-savvy buyers.

         Furthermore, with such a limited definition of what a “clunker” is and the modest fuel efficiency standards that a new vehicle must meet, it is doubtful whether this bill will be a boon to the environment.  Given that it takes a good deal of carbon to manufacture a new car (about 6.7 tons, by one analysis) and that a new car need only receive at maximum 28 mpg—which is only slightly above the corporate average fuel economy—for the purchaser to receive the full $4,500 rebate, it will take about four years for the driver to “repay” the carbon cost of the new car.  That isn’t a bad thing, but in four years we will hopefully be looking at hybrid and electric cars with even greater fuel efficiency at a more reasonable price.  So in that sense, it might be more beneficial to hold onto one’s car a little longer.

         Another way in which this act caters to the auto industry is that there is no provision for used cars.  All traded-in clunkers must be scrapped.  The $4,500 credit cannot be administered to charities or recyclers if car owners were to donate their clunker.  And many people who are driving heavy-emissions vehicles may not be in the position to afford new ones, in which case a mere $4,500 would not help them to finance a new purchase.

         To add insult to injury, the $2 billion extension is being diverted from the stimulus bill’s loan guarantee program for renewable energy projects.  That is an awful misuse of resources given that many states estimate that blackouts will occur in the next few years if grid capacity is not increased.  Plus, urban development and transit expansion will need clean energy sources to maximize effectiveness.  And need I mention the national security imperative of having a network of transmission to our homes and businesses that does not require kowtowing to petro-dictators overseas?

         We need to help our struggling auto industry to reinvent itself; we also need more fuel efficient cars.  What we don’t need is a half-life support/half-token gesture to environmentalists when this money could be used more effectively for other purposes.

Republican Healthcare Speech Template

           Madam Speaker, I rise in opposition to HR 3200, the so-called healthcare reform bill.

            It is clear that this bill will ( raise taxes / kill jobs / kill puppies ).  This bill, which the Democrat majority hopes will move us toward ( socialism / fascism / homosexualism ), is just an effort to make the government take over ( your health / your house / your dreams ).  The Democratic agenda has failed us thus far.  When we look at the record stimulus passed earlier this year, I ask you, ( Where are the jobs? / Where is the money? / Where is the beef? )

            What my colleagues on the other side of the aisle need to understand is that Republicans represent ( small businesses / middle-class families / the insurance conglomerates that finance our campaigns ).  They say that we have no solution. Our party does have a solution: ( cut taxes / cut taxes and increase spending / cut taxes, increase spending, and blame any problems on the Clinton administration ).

            This health care bill will do one thing only, and that is to enlarge our country’s ( debt / bureaucracy / prostate ).  Democrats say that universal healthcare will cost one trillion dollars.  One trillion!  That is enough to buy ( three F-22s / one unnecessary war in the Middle East / every single member of Congress and their staffs ).

            My constituents don’t want a government takeover of healthcare.  They don’t want us to turn into ( Canada / Europe / Nazi Germany, circa 1939 ).  But that’s right around the corner, folks.  I urge my colleagues to vote against this bill, because it is ( too much, too soon / too little, too late / too big to fail ).

Debunking GOP healthcare smears

            Republicans are trying their best to kill health reform and extinguish President Obama’s credibility.  They say they want to improve health care—just not in its current form.  Well, folks, they have had fifteen years to prepare for this moment, and were in charge of Congress for the majority of them, so I’m not sure why they are acting like the new healthcare bill is broadsiding them.

            Today on the House floor, at least two congressmen made the astonishing claim that the bill would abolish private health insurance.  They invited their colleagues to look at pages 16 and 17 of the bill (which shows how far they got in reading it before deciding that they had had enough).  The claim, though, had already been made a few weeks beforehand by right-wing activists: to wit, “Right there on Page 16 is a provision making individual private medical insurance illegal,” wrote Bill Dupray of the DC Republican Examiner.

            Well, it turns out that that is NOT what page 16 says.  I invite you to look at HR 3200 for yourselves.  The provision in question is part of the short section on people who have coverage now and will be grandfathered into the healthcare system once the bill is passed.  These people will keep their coverage (which is the exact opposite of what Republicans are saying) and will even be able to add dependents.  Only if the terms or premiums are changed will they enter the healthcare exchange—the new marketplace created for those looking for coverage.

            Now, there are two explanations for this discrepancy: either Republicans are reading the bill differently from everyone else—and as lawyers, I’m sure they are used to twisting words to find loopholes—or they are lying.  I’ll let you decide.

            The other tactic Republicans are using to misrepresent the healthcare bill is this chart (large version).  I’m sure it has the desired effect on C-SPAN, where the viewer can only see boxes and lines.  But once you read it close up, it’s less outrageous and more commonsensical.

            Now, take a look at this version.  I haven’t done extensive research on this topic, but off the top of my head I have highlighted in white those parts which directly would pertain to you, a current policyholder, if the bill should pass.  Highlighted in green are those agencies, programs, and officials that already exist and may have a peripheral effect on your coverage.  In purple is that which also exists currently and would have no discernable effect on your coverage.  And in yellow appear the apparent creations of the new plan, not all of which are necessarily bad or would lead to rationing or increased costs—inspectors general, ombudsmen, office of civil rights, etc.

            Don’t be fooled by demagoguery.  Learn about it, think about it, and have a reasoned debate about it.  Talking points will be the death of this much-needed reform effort.