About the Author

James C. Capretta

New Atlantis Contributing Editor James C. Capretta is an expert on health care and entitlement policy, with years of experience in both the executive and legislative branches of government. E-mail: jcapretta@eppc.org.
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James C. Capretta’s Latest New Atlantis Articles

 Health Care with a Conscience” (Fall 2008) 

 Health Care 2008: A Political Primer” (Spring 2008) 

 The Clipboard of the Future” (Winter 2008)

 

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Text Patterns - by Alan JacobsFuturisms - Critiquing the project to reengineer humanity

Monday, March 1, 2010

The Myth of “All or Nothing” 

At last week’s Blair House meeting, several Democrats, including Senator Chris Dodd and House Speaker Nancy Pelosi, repeated the standard talking point used by those pushing for passage of a big health-care bill, which is that it is simply not possible to write a sensible plan that isn’t also “comprehensive.”

Unfortunately for those pushing this line at the “summit,” the Wall Street Journal reported the very same day that the White House has already drafted a decidedly non-comprehensive “Plan B.” After Scott Brown’s stunning election to the Senate in January, it apparently dawned on the president that his grand health-care ambitions might actually be going up in smoke. If that dreaded eventuality did indeed come to pass, the president wanted — not unreasonably — to be ready with a “fallback” plan, one that would cost much less than the bills the House and Senate passed in 2009 but that would still do something positive from his perspective. As reported by the Journal, the president’s staff dutifully complied and put together a package of public insurance expansions and other changes that would cost roughly one-fourth of the “big bill” while still covering some 15 million more people with health insurance.

Of course, just because a plan is incremental does not mean it would entice bipartisan support. This particular version of an incremental plan probably wouldn’t get much Republican interest, given the heavy emphasis on expanding public insurance. It’s an incremental package, yes, but in a decidedly Democratic direction. Other versions with a nod to private insurance almost certainly would attract some Republican votes.

Still, the very existence of the Obama team’s fallback plan should embolden those Democrats who are now resisting their leadership’s pressure to take up the full Obamacare package in coming weeks and pass it. There are plenty of alternatives to passing a massive and risky rewrite of American health care. It’s not “all or nothing,” and never has been. If Obamacare were to be set aside at last — to the great relief of voters everywhere — the president and Congress would still have plenty of time in coming weeks to take up and pass a less ambitious but still significant measure.

The problem for Democrats is that they always dream of putting in place the next New Deal or Great Society. At his State of the Union address in January 1994, President Clinton famously brandished a pen at the Democratic Congress and threatened to veto any health-care bill that didn’t “guarantee every American” health insurance. He never had to deliver on that threat because no bill was ever sent to his desk.

Now, President Obama and his congressional allies have fallen into the same trap. Witness all the comparisons in recent days to the enactment of Social Security and Medicare. That’s the Democrats’ ideal. Their goal is “universal coverage,” but what that really means is another sweeping entitlement that permanently changes the relationship of the middle class to the federal government.

Late last week, the White House announced additional appointments to the “fiscal commission” created by the president, which is supposed to make recommendations on long-term entitlement reform. Most Democrats seem not to have noticed the irony of rushing to lock in another massive entitlement even as they admit they have no earthly idea how to pay for the ones already on the books. But it would seem the American people have, by and large, noticed. Which is why they are in no mood for a “historic” signing ceremony which would only make matters worse.

posted by James C. Capretta | 8:27 pm
Tags: White House plan, Obamacare, Bill Clinton
File As: Health Care