"If you and I had done the back room deals and the payoffs that this bill took to get passed for every one of those votes, you and I would be guilty of corruption. We would have been arrested for corruption," the governor of Nevada, Jim Gibbons, tells Fox News. "The state of Nevada is no different than many states who believe that this is an unconstitutional law created by the federal government in the back room."
I'm sympathetic to the Nevadans whose tax dollars are going to be taken by force to pay extra for the health care of Nebraskans who were lucky enough to have a senator who was a swing vote on the bill. On the other hand, special deals to accomodate the interests of certain states are a feature of American democracy going back to the Constitutional Convention, which itself was a closed-door meeting, "with armed sentinels posted outside convention doors."
The House vote on expansion of Medicare to include prescription drugs back in 2003 was another example, with Speaker Pelosi charging, "They spent billions of dollars of the taxpayers' money trying to win that vote." (Sound familiar?) That vote lasted three hours, from 3 a.m. to 6 a.m., and the Medicare expansion ultimately triumphed 220 to 215 when three Republicans changed their votes to yes from no. One Republican congressman who voted against the bill reported that Republican leaders threatened to raise money for the opponents of his son, who hoped to succeed him in his congressional seat. The House ethics committee ultimately rebuked Tom DeLay over the episode.
Anyway, it's interesting to see the Republicans who were arm-twisting every last vote back in 2003 all of a sudden turn into a bunch of good-government process liberals now that the shoe is on the other foot.
As we've said before, the problem in Washington isn't the Republicans or the Democrats, it's the politicians.
That doesn't make the pill any easier to swallow for the Nevadans stuck paying for the health care of Nebraskans. They are like the Ford shareholders and employees stuck subsidizing General Motors. When government has the power to redistribute wealth, there will be winners and losers. The losers can respond either by trying to increase their share of the money, or by trying to reduce the size of government so that there is less money to redistribute in the first place. The politicians in Washington, though, aren't very good at reducing the size of government, in part because doing that decreases their own power, their ability to issue press releases about how much funding they are delivering to their local causes and institutions, and their ability to solicit campaign contributions in exchange for such funding.
It's all a bit disillusioning for those reared on civics lessons about the grandeur of the American democratic process, but oddly enough I am more upbeat about it than a lot of my friends on the right. Remember, from 1980 to 2007, a 27-year period in which there were 19 years of Republican presidents and eight of Democrats, total government health care spending in America grew to $1.036 trillion in 2007 from $106 billion in 1980. The government share of health care spending also grew from 1980 to 2007, to 46% or 45%. And it was set to increase even more with the retirement of the baby boom generation. All this happened pretty stealthily. Obamacare at least has the virtue of bringing this government spending and its effects on the federal budget and on overall health care cost and quality into the fore of the political debate, so that if there is rationing, unsustainable cost increases, or unacceptable quality lapses, at least it will be clear whose fault it is. If Obamacare passes, it will be harder to blame the insurance companies or the drug companies or the doctors for problems with health care; under the Pottery Barn Rule, the Democrats, or, more broadly, the federal government, will now own everything that's wrong with health care in America. If you are a Democrat who thinks that Obamacare is going to reduce the deficit while improving quality without rationing, then you shouldn't be worried by that; in fact, you probably think the voters are going to be grateful to the Democrats for fixing health care. But if you are a free-market type who thinks that central planning doesn't work and that government programs produce unintended consequences and turn out more expensive than they were originally intended to be, then at least Obamacare will have the virtue of turning the government role in health care into a potent political issue, which, at 45% of health care spending and $1.036 trillion in 2007, it wasn't.