The right and left wings of the Republican and Democratic Parties do not appear to have symmetrical tactics. The right, usually in the House but often in the Senate, refuses to compromise even when that refusal will generate a worse short-term result from their perspective. For instance, the right in the House has refused to vote for federal spending bills even if they were written by the Republican leadership. In 2012, the most conservative caucus refused to vote for a bill that would have limited tax hikes to those earning over a million dollars a year. And they have blocked some of the compromises that might smooth the passage of a partial Obamacare repeal and health care reform.
As a result, the Republican leadership has had to rely on Democratic votes for the budget, leading to higher spending. Without the leverage of the House bill taxes went up on couples earning over $450,000. The prospects for any substantial legislative reform of health appear dim.
In contrast, the Democratic left is willing to compromise. They all voted for Obamacare, even if it was not a single-payer plan. And I do not recall any substantial opposition to budgets passed in the Democratic Congress. What explains this difference?
One of the most frustrating aspects of the debate about how health care should be governed is the mistaken claim that the world prior to Obamacare involved free market health care. This, of course, is nonsense. That health care world was the product of a mixed system – of markets in health care combined with a myriad of government regulations combined further with the government provision of health care under various programs. In my view, this system is responsible for many of the infirmities that people complain about with respect to health care and health insurance, such as problems with preexisting conditions, cost escalation, bureaucratic procedures, and health insurance access problems for people with low income.
I expect if one were to ask Republicans in the House of Representatives and Senate (and the White House) whether they want Obamacare replaced, all, or close to all, would give a hearty “yes.” Where things break down is what replacement proposal could get majority support in the House, and the requisite majority or supermajority in the Senate.
House Speaker Paul Ryan’s and, apparently, the White House’s assessment as well, was that moving last week’s proposal to the right to satisfy members of the Freedom Caucus in the House would lose the pivotal votes in the Senate, and insure defeat there.
Could the market help us solve our healthcare problems? Market economists and theorists say of course it could; big government/Progressive types say no. Let’s find out. As Franklin said when discussing his famous Kite, “let the experiment be made.” When the Obama administration was debating just how heavily to regulate America’s healthcare system, many on the Left wanted a truly government-run health insurance scheme, or “public option.” As Progressives’ default assumption is that government programs work better than the alternatives, they believed a “public option” would demonstrate the wisdom of turning to fully socialized medicine in the United States. Average Americans reacted sensibly:…
The most revealing executive action of the new administration may have been among the least reported. President Trump, by memorandum, ordered the Secretary of Commerce to “develop a plan” under which all new, retrofitted, repaired or expanded pipelines inside the United States would use U.S.-made materials and equipment “to the maximum extent possible and to the extent permitted by law.”
Cutting to the chase, the extent permitted by law is zero. The president of the United States neither has nor ought to have the authority to tell private companies making private investments where to buy their equipment or materials. He has no authority to encourage them, pressure them or bully them. The conservative response to a comparable order from President Obama would, appropriately, have been apoplexy.
The first constitutional test of the new era will be answered less by Donald Trump than by Mitch McConnell (R-Ky.) and Paul Ryan (R-Wis.): namely, whether the congressional leadership delivers to the chief magistrate the news that Capitol Hill is not a subsidiary of the White House.