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The conservative effort to undermine health-care reform

I'm really not sure why conservatives are so excited that an electorate primarily made of Republican primary voters passed an anti-individual mandate ballot initiative in Missouri. I don't even understand why conservatives would be excited if it passed during a normal election.

For one thing, states can't invalidate federal laws. If a Republican Congress privatized Social Security and Vermont didn't like it, a ballot initiative wouldn't invalidate the law. If Paul Ryan passed his legislation to turn Medicaid into a program of vouchers and private insurance options, Massachusetts couldn't overturn it. The federal government has long resisted letting states decide which federal laws to follow and which to avoid. It will continue to resist.

Moreover, the focus on the individual mandate speaks to how weak the conservative case against the bill is. The individual mandate can be replaced. That wouldn't be a good thing, but you could substitute automatic enrollment, or some form of lock-out. Remember, Barack Obama's campaign health-care plan didn't have an individual mandate. The individual mandate, in fact, originated as a conservative idea. It's a good idea, in many ways, but it's not irreplaceable.

Much more dangerous is the Republican strategy to refuse to appropriate the funds the bill needs. But Republicans are going to have to think hard about that one: If they set the precedent that one side can erode legislation they don't like by refusing to fund it, the same is going to happen to their eventual accomplishments. Policy stability will disappear, as it will become normal for the opposition party to defund the other side's legislation when they take power. This wouldn't be the first time Congress has made a disastrous move toward gridlock and dysfunction, but it would be the one that scares the business community the most, as it would effectively end their ability to plan for the future.

By Ezra Klein  |  August 5, 2010; 12:05 PM ET
Categories:  Health Reform  
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Comments

You assume that the Republicans will have "policy accomplishments" Dems could actually defund. It seems to me that you can't defund a tax cut, and they won't defund any war funding.

Posted by: mschol17 | August 5, 2010 12:14 PM | Report abuse

Health care (transformation) is one of the best issues this current administration has done thus far. With this change individuals will have the opportunity to seek professional and quality health care services. Who would want to return to the days of the horse and buggy, b/w tv sets, manual typewriters, pac man, you get the point? That's about how old the health care system was in the USA. Each day the news is filled with social tragedies in which lives are taken at the hands of known acquaintences and/or family members. Our society is stricken with the institutions of white collar crime permeating throughout this great nation and greed which tends to strike at the very fabric of our country. If you are looking for affordable health insurance check out http://bit.ly/chE6zp . I hope everyone will soon recognize and use the resources made by this transformation to seek professional medical attention as the need arises rather than turning to illegal and criminal activities to resolve their issues.

Posted by: caryblair | August 5, 2010 12:21 PM | Report abuse

Unless I've misread Article V, thirty-eight states can invalidate any federal law.

Now that a supermajority of Missouri citizens has joined a bi-partisan majority of Virginia legislators in rejecting the PPACA's unprecedented intrusion into matters which are the sole domain of states and individuals, public consensus opposing the PPACA will grow more rapidly: until now, it has been possible for left-wing propagandists to invent and publish numbers which mask the true level of opposition to recent federal incursions.

At no time has the Obama/Pelosi PPACA enjoyed the support of a simple majority of citizens: the majority supports freedom and is no longer willing to be silent.

Posted by: rmgregory | August 5, 2010 12:34 PM | Report abuse

rmgregory,

38 states won't invalidate this law. Good try!


Any net positive result to this for Republicans is about energizing their base for November and beyond and sapping energy from Dems.

Funny I haven't seen a "prediction" or graph lately from Ezra on the upcoming November elections. I'd ask for that in research desk but for some odd reason I only see liberal talking points in there.

caryblair,

STOP SPAMMING!!

Posted by: visionbrkr | August 5, 2010 12:37 PM | Report abuse

rmgregory,

In the event the individual mandate is eliminated I'd imagine Congress could simply create a tax deduction for insured status that would have the same basic effect (e.g. Congress eliminates the standard deduction and exemptions and replaces them with an equal sized 'health insurance deduction'). It's hard to see how attacking the individual mandate is going to work.

Posted by: justin84 | August 5, 2010 1:05 PM | Report abuse

You said it yourself, Ezra, the voter turnout numbers don't bode well for the Democrats in November. That's pretty exciting.

Going the mandate route was really a stupid move on the Democrats' part. Not only does it create enormous hostility, it's unworkable, difficult to enforce, and laughably inadequate. They should have just provided for periodic open enrollment periods and penalize those who choose to opt out with limitations for pre-existing conditions. Had they done so, they wouldn't be faced with near the level of constitutional challenges and voter hostility they are faced with now. But they could hardly have enacted pre-existing condition limitations after demonizing insurance companies for doing so.

Republicans won't think twice about "fixing" Obamacare, including jacking around with the funding, if they think the voters put them into office to do just that. You may just grow to love the filibuster after all.

Posted by: bgmma50 | August 5, 2010 1:07 PM | Report abuse

On the other side of the political spectrum, what happens if California votes to legalize the recreational use of cannabis? To my understanding, no federal law exists that specifically makes cannabis illegal, but does delegate the regulatory classification of it to the executive. The Supreme Court has already upheld the exclusive ability of the executive branch to regulate cannabis, but the states still allow it to go on relatively unprosecuted by state and local law enforcement.

Are these two issues birds of a feather, or what am I missing?

Posted by: Jaycal | August 5, 2010 1:26 PM | Report abuse

Ohhh, Ezra, it's just so darn CUTE that you think the Republicans think beyond this election cycle.

"But Republicans are going to have to think hard about that one: If they set the precedent that one side can erode legislation they don't like by refusing to fund it, the same is going to happen to their eventual accomplishments."

They don't care, Ezra. They either think a) that they'll regain power and hold it indefinitely or b) that the earth will end in about 3 or 4 years, so whoever gets the most toys in the next 36 months wins.

(I admit, I spend too much time reading BaloonJuice, and now I'm a snarktivist, but really, at it's core, I'm serious about the above, mainly about the GOP not being able to understand the long-term consequences of their actions. No-one smart or strategic seems to be calling the shots over there).

Posted by: RalfW | August 5, 2010 1:34 PM | Report abuse

I like Paul Starr, but as an actuary, I don't believe his lockout idea will work in practice. For starters, the reach of the subsidies is so low. A single guy earning as little as $46K/yr. is inelligible for subsidies, so what would a five-year subsidy lockout really do to deter him from waiting until he is left quadriplegic from a skiing accident to purchasing health insurance?

Even worse, there are usually all kinds of exceptions with the five-year lockout from subsidies. Fertility is the best example. So people will still be allowed to wait until they get pregnant, and then purchase health insurance.

At the end of the day, the tax penalty is still, I believe, the best way to prevent people from weaving in and out of the system, although I believe the current tax penalty is way, way too lenient. [Of course, this is understandable because the subsidies are so inadequate.]

Posted by: moronjim | August 5, 2010 1:41 PM | Report abuse

1) How many Washington Post staffers were part of JournoList and, if there are any currently unnamed, who are they?

2) Will the Post be transparent and either release or order its staffers to release their contributions to the list?

3) Will the Post release the names and affiliations of all those on the list or have its staffers do so?

4) Did the Post know about JournoList when Klein was hired and that it was a “center to left” group? If yes, what does that say about the Post’s claims of neutrality?

5) Did actions on JournoList violate the Post’s ethical guidelines?

6) Has the Post revised or added any ethical guidelines as a result of this scandal?

7) Will the Post permit staffers to belong to or operate such lists in the future?

8) Does the Post often embrace “off the record” e-mail conversations with hundreds of people at a time?

9) Was Klein’s supervisor(s) on the list and were they monitoring what went on?

10) Has the Post examined the possibility that JournoList impacted Post news coverage?

11) How much did the Post look into JournoList before hiring Klein?

12) Were Klein and the other Post members of the list using it and posting to it on company time? If not, when were they doing so?

13) Did Klein and the other Post members write to the list using company equipment and offices?

14) Was Klein aware that some were using the list to boost the Obama campaign, such as adviser Jared Bernstein?

15) Did Klein attempt to enforce a rule against campaigning and, if so, how?

16) Did Klein post written guidelines for all members of the list? If so, what were those guidelines?

17) Klein had said on The American Prospect on March 17, 2009: “There are no government or campaign employees on the list.” That has been proven false. How did he try to monitor this issue? Were there other members of the Obama campaign and administration on the list?

18) Did Klein ban anyone from the list?

19) Has Klein or any other Post staffer (other than Dave Weigel) offered to resign because of their contributions to the list?

20) When Klein shut down the list, did he delete the list? If not, will the Post order him to release it so that readers may decide for themselves?

Posted by: JoeJeffersonn | August 5, 2010 1:44 PM | Report abuse

what they are doing is watching to see what the American people want and they will campaign on it.

Something like the Dems with Hope and Change.

Duh It's politics so stop looking for things that are not there.

Both parties do it and people like Klein here, make it sound like it is a conspiracy.

Grow up and stop with the partisan crap. I for one am sick of it because all the stupid people actually listen to what you say. THAT is more scary than what any political party says

Posted by: ieklein | August 5, 2010 2:03 PM | Report abuse

When the GOP dominates, imbecility gets another go-round.

Posted by: snowyphile | August 5, 2010 2:05 PM | Report abuse

as usual... short and sweet and right-on.

Posted by: Geopolitics101 | August 5, 2010 2:08 PM | Report abuse

For one thing, states can't invalidate federal laws.
===========================================
Interesting. Isn't it a federal law: "one vote per citizen?" Isn't NJ breaking federal law by allowing a community to vote six times for one candidate because "the Latino community is under-represented"? I don't suppose that the Justice Dept. wants to look into this one.

Health care and small business. Another interesting take. In order to qualify for certain tax credits, a small business must have 25 or less employees. But many of these businesses are being allowed next to nothing OR no tax credits according to a formula by the feds. AND, if the feds determine that you don't qualify for these tax credits, you will no longer be allowed to consider yourself a small business. Will minority owned small business be given preferential treatment over other business owners? My quess is Yes.

Posted by: bethg1841 | August 5, 2010 2:12 PM | Report abuse

First of all, Klein's headline is inflammatory. Republicans and Independents (he neglected mentioning) are not trying to undermine health-care reform.
The Obamacare fiasco, the foundation of which is bribes, abuses, secrecy behind closed doors, and complete disregard of the American tax-payer public is not health-care reform; it is nothing more than an abuse of power and imposed mandate that has become the legacy of a short but failed presidency.
So, if there is some celebration over the Missouri vote, it is because it is part of the beginning of "throwing the bums" out along with their corrupt methods of pushing their agendas on Americans. This is a small preview of November.

Posted by: pjcafe | August 5, 2010 2:13 PM | Report abuse

First of all, Klein's headline is inflammatory. Republicans and Independents (he neglected mentioning) are not trying to undermine health-care reform.
The Obamacare fiasco, the foundation of which is bribes, abuses, secrecy behind closed doors, and complete disregard of the American tax-payer public is not health-care reform; it is nothing more than an abuse of power and imposed mandate that has become the legacy of a short but failed presidency.

So, if there is some celebration over the Missouri vote, it is because it is part of the beginning of "throwing the bums" out along with their corrupt methods of pushing their agendas on Americans. This is a small preview of November. This is a egotistical, arrogant president who lacks concern for America or what Americans think.

And, you Mr. Klein, are part of the travesty of promoting the fraud of this administration.

Posted by: pjcafe | August 5, 2010 2:15 PM | Report abuse

They are mostly Republican Primary voters because the usual-Bellweather Missouri has comlpletely collapsed and no one will vote for a Democrat again their anytime soon......how many voters voted for Carnahan? Didn't Obama just campaign there for her? How is all that going!?

Posted by: FastEddieO007 | August 5, 2010 2:18 PM | Report abuse

Does it trouble you Dems that it was mostly Republicans voting during the primaries of Robin Carnahan and Roy Blunt?

http://news.yahoo.com/nphotos/slideshow/photo//100730/480/urn_publicid_ap_org_a0dc0871098d48089d76f86b190210a3/?.src=news

Posted by: FastEddieO007 | August 5, 2010 2:21 PM | Report abuse

U.S. Rep. Roy Blunt will face Missouri Secretary of State Robin Carnahan in the open U.S. Senate seat this November. Blunt easily won the Republican primary Tuesday with 409,806 votes (70.94 percent). On the Democratic side, Carnahan defeated her opponents with 264,742 votes (83.83 percent).

Posted by: FastEddieO007 | August 5, 2010 2:23 PM | Report abuse

520,000 people voted in the Republican Senate Primary. Less than 300,000 voted in the Democrat Senate Primary---a primary that had the USA President campaigning in.

What does that tell you about the Bell Weather winds?

Posted by: FastEddieO007 | August 5, 2010 2:26 PM | Report abuse

If the Virginia courts move forward with the decision not to mandate all Virginians to purchase a health insurance plan, then who is going to pay for those visiting the emergency room for medical treatment? The good citizens of Virginia should not be held liable for the ignorant of their attorney general but I do not want my federal tax dollars to pay for Virginians who are given the right to opt out of purchasing a health insurance plan.

Posted by: sun52shine | August 5, 2010 2:27 PM | Report abuse

"The federal government has long resisted letting states decide which federal laws to follow and which to avoid."

Yes, Ezra. Unless of course you are a state/city which decides you don't want to follow immigration law, and decide you want set up 'sactuaries' for illegal immigrants. Then the libera....errrr, "federal government" is happy to let you decide which laws you want to follow.

Count on Ezra to once again expose the half-baked philosophy that is liberalism.

Posted by: dbw1 | August 5, 2010 2:28 PM | Report abuse

Ezra Klein of "Journolist" fame is an example of the very worst in propaganda, fraud, deliberate misleading statements and distortion of facts.

That he is employed at all is an absolute mystery.
He and Chris tingly Matthews. et al are ridiculous clowns.

Enough said -

Posted by: pjcafe | August 5, 2010 2:29 PM | Report abuse

sun52shine:
"I do not want my federal tax dollars to pay for Virginians who are given the right to opt out of purchasing a health insurance plan."

And people in Idaho don't want to pay for abortions in New York. You're reaction is the perfect illustration why something like health care should be left to state-by-state regulation, not one-size-fits-all reform that liberals try to ram-rod down everyones throat.

By the way, for several years now everyone's federal tax dollars have been going to subsidize the state-run Massachusetts plan that Democrats everywhere were pointing to as the model for ObamaCare....because the Massachusetts plan was bleeding red ink (pardon the pun). Does that bother you?

Posted by: dbw1 | August 5, 2010 2:34 PM | Report abuse

Sigh. I wish the trolls would go away.

Posted by: mschol17 | August 5, 2010 2:37 PM | Report abuse

You reap what you sow Ezra. The Democrats rammed through Obamacare, through shear force of numbers, a bill so partisian it couldn't even attract the liberal Maine senators to vote for it and now you're going to cry foul because Republicans are talking about defunding portions of a piece of legislation they have no ownership of. What did you expect?

Posted by: RobT1 | August 5, 2010 2:37 PM | Report abuse

Ezra says:
"Policy stability will disappear, as it will become normal for the opposition party to defund the other side's legislation when they take power. This wouldn't be the first time Congress has made a disastrous move toward gridlock and dysfunction, but it would be the one that scares the business community the most, as it would effectively end their ability to plan for the future."

Ezra might note that nasty surprises in the massive Obamacare and finreg laws are popping up which are still being decoded.

Businesses are already scared about Obama's agenda and that is what scares them. The incomprehensible 2,500+ page bills caused businesses to halt or pull back on hiring. Obama's vitriol against businesses also contributes to the current climate of fear.

Posted by: spamsux1 | August 5, 2010 2:39 PM | Report abuse

"This wouldn't be the first time Congress has made a disastrous move toward gridlock and dysfunction, but it would be the one that scares the business community the most, as it would effectively end their ability to plan for the future."

Gridlock cuts both ways. It doesn't necessarily mean independent voters or businesses favor a GOP takeover of Congress. Some merely prefer not having one party holding the presidency and both houses of Congress at the same time. Conventional wisdom says gridlock provides time to digest the sweeping changes that have already been made. Obama fought for and got financial re-regulation and health insurance reform. Unfortunate that unemployment wasn't addressed with more vigor in his first 12-18 month window of opportunity. The midterms would be looking less scarier for Dems if a few million more Americans were employed. Just hope the post-election obit isn't, "It was the economy, stupid."

Posted by: tuber | August 5, 2010 3:31 PM | Report abuse

Prop C was a 70% - #0% against Nobama's HC. And that's Missouri a swing state. Yep - that will pretty much also be the voting trends in many of the elections - and not favorable towards the Dems I may add. They have lost the independent vote in droves....they have implemented far left policies - further than one imagined. i cant wait for November.

Posted by: short1 | August 5, 2010 3:35 PM | Report abuse

That MO (which went for McCain in 2008) Republicans voted against health care reform is reminiscent of Republican acquaintances telling me that 'the people' did not vote for this or that Obama initiative.

Since Obama won the popular vote, then by definition those who voted for McCain do not know what the people voted for.

Posted by: AMviennaVA | August 5, 2010 3:39 PM | Report abuse

rmgregory @ August 5, 2010 12:34 PM wrote "Unless I've misread Article V, thirty-eight states can invalidate any federal law."

You did misread it: 38 states (since we have 50 in the Union) are needed to approve an amendment to the Constitution.

That is a far cry from invalidating federal law.

Posted by: AMviennaVA | August 5, 2010 3:42 PM | Report abuse

"If they set the precedent that one side can erode legislation they don't like by refusing to fund it, the same is going to happen to their eventual accomplishments."
The precedent has already been set. It's called politics as usual. The examples which spring to mind are such things as the B-1 bomber, which was a football back in the 70's and 80's. The Reps have killed a number of Dem programs by "block-granting" them. The bottom line: to survive, health care has to be or become popular. Nothing else will keep it going.

Posted by: bharshaw | August 5, 2010 3:55 PM | Report abuse

Ezra, you have just convinced me that you are too smart for your own good to be able to understand the simple realities of American politics. If you don't start getting more real politically, all your policy expertise will be for naught.

#1, The Mandate IS the health care law. That is the thing that touches people's lives. All the little unenforceable suggestions against rescinding care won't matter a whit to the claims deparments of the private insurance monopolies.

#2, By exposing the mandate as terrible unpopular idea, the Republicans will retire many Democrats. I say this as a liberal. The political implications of the mandate are much more important than the policy ones, because the policy is unlikely to ever see the light of day: given the extremely flimsy defense of the mandate that has been made in court, the SCOTUS is more likely than not to repeal it.

#3, You don't understand how Republicans work. First of all, of course they will destroy Medicaid funding, that's why that part of the ACA was always riddled with swiss cheese-loophole meaninglessness. Secondly, as Mschol17 says, what in heaven's name do you expect in the way of accomplishments from future Republicans, besides tax cuts?

Posted by: michaelh81 | August 5, 2010 4:37 PM | Report abuse

Ezra: I'm trying to find the pieces you wrote in 2007 and 2008 where you cautioned Capitol Hill Democrats that "policy stability will disappear" if they pressed ahead with their efforts to end the war in Iraq by refusing to appropriate funds for it. So far, no luck. Can you give a hint?

Posted by: dufffy98 | August 5, 2010 6:04 PM | Report abuse

Someone should ask the Missouri Republicans whether they understand that RIGHT NOW they are paying much more than they have to in healthcare premiums and taxes -- federal, state and county taxes -- in order to cover poor people (and to cover people without healthcare who could afford it, i.e. clowns who scream about "liberty") -- because these people are showing up at the last moment in the worst possible condition at the least efficient and most costly place, the emergency room.

Ask the Missourians whether they understand that the U.S. healthcare system is causing less economic growth for us all, because poorer workers, worrying about healthcare for themselves or their children, are much less productive workers.

And especially ask the Missourians whether they understand that U.S. businesses are losing to global trade because U.S. labor cost is too high -- and a big component of that is U.S. healthcare cost. U.S. businesses are relocating to countries where labor is cheaper because among other things the workers have universal healthcare of one sort or another -- and then sell the cheaper products back here. Brilliant! Do Missourians understand that this market won't equalize, that they are shooting themselves in the foot?

Pure economics is one reason why the mainstream Republican Party has been making noises toward healthcare reform for a long time (half of Obamacare is Republican ideas). So I think that, as Ezra indicates, the party is going to have problems being coherent on this issue in the future. My sense of it is that the mainstream Republican Party (country club) hates the teaparty so much (the feeling is mutual) that they'll try to figure out a way to throw them a bone, such as give the teapartyers a healthcare insurance waiver if they promise to take strong psych meds.

Posted by: Lee_A_Arnold | August 5, 2010 8:19 PM | Report abuse

Also, many Democrats are angry because of course we are all being mandated to pay money to private insurers, i.e. corporations that have hidden behind the market philosophy of "profits" while ruining people's lives. This anger was foreseen for the last year at least.

And indeed, opinion polls around the time of healthcare's passage in March indicated that about 12-13% of the population opposes ACA because they want it to be MORE LIBERAL: e.g. have a nonprofit public option that you can CHOOSE if you want. Some of these people understand the need for the mandate, they just don't want to pay more money that necessary. Some of these people have probably joined the teaparty in a populist rage. But a public option would bring them back, and put the percentage in favor of ObamaCare immediately up to around 55% for starters.

CBO just scored the House public option proposal last week, and it will save 5-7% on everyone's premiums, AND reduce the federal deficit.

What in hell are we waiting for? It won't get through the September pre-election session of Congress, but the supporters in Congress might at least make a LOT of public noise about it and get the opponents on record, so we can be reminded who our enemies are just in time for November 2.

Posted by: Lee_A_Arnold | August 5, 2010 8:23 PM | Report abuse

. U.S. businesses are relocating to countries where labor is cheaper because among other things the workers have universal healthcare of one sort or another -- and then sell the cheaper products back here. Brilliant!
Posted by: Lee_A_Arnold | August 5, 2010 8:19 PM | Report abuse


Lee,

universal healthcare??? You do realize those other countries pay it but in TAXES, right? Sure its still not equitable and more costly here but you don't think that in those countries like China and India it has to do with sweatshops more than universal healthcare? I don't know much about China but India doesn't have universal healthcare to my understanding.

Its about cheap labor over there. End of story. Sorry that doesn't fit into your neat little talking points.

If you shove labor unions and our labor costs over on China and India we'd suddenly see more manufacturing done here.

Posted by: visionbrkr | August 5, 2010 8:37 PM | Report abuse

Visionbrker, No, on two counts: (1) In a discussion of the comparative costs of healthcare, it doesn't matter how you pay it. Some countries pay it in taxes, that's no different than a mandate, and our major competitors on average pay 40% less.

China's healthcare system is in transition and India has a two-tier structure, nonprofit+private, as I believe the U.S. ought to have. But let's leave aside the example of any particular country and look at basic economics:

(2) If and when labor conditions improve in every country so that they have more or less the same labor costs, and countries all rectify their business taxes and so on, then everything will be equal -- EXCEPT U.S. labor costs. Companies will stay overseas because the U.S. will have higher labor costs because U.S. healthcare costs are higher. What is happening now, will stay that way. And what is happening now, might be partly prevented now.

Posted by: Lee_A_Arnold | August 5, 2010 9:46 PM | Report abuse

Lee,

I'm not going to go tit for tat with you because i don't need to. You're wrong. After this I'm done.

http://en.wikipedia.org/wiki/Healthcare_in_India


However, the government sector is understaffed and underfinanced; poor services at state-run hospitals force many people to visit private medical practitioners.

In recent times,[when?] India has eradicated mass famines, however the country still suffers from high levels of malnutrition and disease especially in rural areas. Water supply and sanitation in India is also a major issue in the country and many Indians in rural areas lack access to proper sanitation facilities and safe drinking water.

--------------------------

We shouldn't strive to get to India's levels there.

http://en.wikipedia.org/wiki/Healthcare_reform_in_the_People's_Republic_of_China

The Chinese government still faces a mammoth task in trying to provide medical and welfare services adequate to meet the basic needs of the immense number of citizens spread over a vast area.


-------------------------

Facts are really hard to get past.

Let me know when labor gets resolved in China. More possible with India but still not likely. Anytime you want to go live in either place, I'll gladly buy you a ticket.

Posted by: visionbrkr | August 5, 2010 10:41 PM | Report abuse

The Supreme Court ruled in Prinz vs US that States do not have to enforce federal laws. Nice try!

Posted by: Dude58681 | August 5, 2010 11:14 PM | Report abuse

Visionbrkr, No, this is basic economics. It is not about India's absolute conditions, because those conditions will change. It's about the per capita health spending that India will move into. The Wikipedia article clearly shows that India has structurally a two-tier health system: nonprofit government + more private coverage available on top. This is structurally identical to, say, Switzerland, Germany, and France. So if India progresses through economic development to the BETTER level of the two-tier healthcare in, say, France (where the bottom level is an adequate nonprofit coverage and the top level is private healthcare that is as good as anywhere else in the world), then India will still be spending 25-50% less per capita than the U.S. -- as France, Germany, and Switzerland already are doing. Total healthcare costs for each of these countries = government-mandated nonprofit + discretionary private coverage = on average 40% less per capita. That is automatically a competitive disadvantage for U.S. labor, and it is going to become VERY important. Because as global trade gradually EQUALIZES the standard of living everywhere, which economics says is bound to happen among nations (and is going to happen much faster than you might think), then the U.S. will REMAIN with that competitive disadvantage. U.S. business goes to India now for cheaper labor, and it will STAY there. Of course there are lots of other things that affect comparative advantage, but this one will remain in effect until the U.S. gets healthcare costs much lower.

Posted by: Lee_A_Arnold | August 6, 2010 12:19 AM | Report abuse

More spewing from the journolist.

It might even be based on facts.

Then again it might not.

Posted by: TECWRITE | August 6, 2010 8:26 AM | Report abuse

dont be deliberately obtuse mr. klein. the only reason obama broke his promise to oppose the individual mandate on principle was because he said he came to realize that it was a practical necessity in making the bill affordable. its on video. so, without the mandate he would essentially be defending a bill that can't work. good luck to with that one.

Posted by: dummypants | August 6, 2010 8:45 AM | Report abuse

>If they set the precedent that one side can
>erode legislation they don't like by
>refusing to fund it, the same is going to
>happen to their eventual accomplishments.

To a fiscal conservative like me, what's the downside to that?

Both the Republicans & Democrats have been expanding government far too much. If they start de-funding each other's pet projects, that's a win.

If you make federal policy unstable for business, that's a win. It means the businesses can no longer use their money to lobby for special treatment on the taxpayer's dollar, that's a win.

We got Capone not for his real crimes, but tax evasion. You cure illegal immigration not by some magic fence, but by going after employers who enable them. Perhaps the best solution for a Federal government who has grossly overreached it's constitutional authority over the last fifty years and whose spending is prolific is to let it collapse under the weight of it's own largess...it has become a cockroach upon this nation, a cockroach too big for it's exoskeleton to any longer support it's weight.

Posted by: Dal190 | August 6, 2010 8:45 AM | Report abuse

I'll take a double helping of gridlock, please. And I still can't believe this guy is employed.

Posted by: ADNova | August 6, 2010 8:50 AM | Report abuse

Im a St Louis MO resident who voted Yes on Prop C. I dont need to explain anybody my reasons, which are many, to dislike Obamacare. I need no apologize to anybody; Im not some redneck, or hillbilly or nutter or fill-in-the-blank usual namecalling from Liberals; but the reason Im posting here is because Im genuinely surprised to see another Ezra Klein article in WashPo. I thought his journalistic deficiencies has been exposed after the Journolist Fiasco; I thought WashPo had fired him. Instead, here is the kid telling ME what is good for me and my family. Keep up the good (condescending and patronizing) work liberals - see you in November.

Posted by: CuriousCitizen | August 6, 2010 8:57 AM | Report abuse

I also am from Missouri and voted yes on Prop C. As CuriousCitizen above states I also find Ezra extremely condescending. I will decide what is best for myself and my family. The gov't does not have the right to force me to buy any product.
My gosh, are so many of you so helpless that you need the nanny state to attend to every detail of your life? How pathetic.
Federal government does little well. Over the years it has done military well. This is one of the few areas in which it should be involved.
It seems to me that often it is just a matter of efficiency. There are no perpetual motion machines. Energy in never equals energy out. Some is always lost. In all things government it seems that much is lost (although with gov't it is in the form of $). Typically, the private sector does things more efficiently. They have an incentive. If they don't, they go broke and go away. Government, on the other hand, just taxes more. There is no disincentive for failure, often, quite the opposite, you just get more money and/or expand your power base.
People running for office that want get want to limit the power of the federal gov't are portrayed as kooks by those such as Ezra. I believe that Ezra, and those that think like him are in for a rude awakening come November. Assuming there is an election.
If you would like to read someone that taps into what I believe many of us feel take a look at Peggy Noonan's article at the Wall Street Journal today:
http://online.wsj.com/article/SB10001424052748703748904575411713335505250.html?mod=WSJ_Opinion_LEADTop

Posted by: MOvoter | August 6, 2010 9:21 AM | Report abuse

Oh little boy klein, the keitholberman/chrismatthews wanna-be...You remind me of a teenager, think you know everything - well, if you want to live in a society filled with social programs, please move to canada - and bring your MSNBC buddies with you.
November 2nd...

Posted by: civilemik | August 6, 2010 9:24 AM | Report abuse

MOvoter says: "Assuming there is an election."

Tell you, I've been called paranoid and hysterical in other blogs when I used the same language above - but after this Admin imposed (as in jammed down our collective throats) the HCR, then downgraded the AZ Immigration law, which had 70% of AZans support - 60% nationwide, now debunked the CA Prop 8, is dismissing and calling "insignificant" the MO 70% prop C results, etc, I have began to wonder if they can actually cancel out the elections all together!

PS: whether people agree or disagree with AZ, Prop 8, Prop C, etc, is not even the point - is that seems to me the will of the majority is simply becoming meaningless and the power in the few in DC kind of like a mild tyranny.

Posted by: CuriousCitizen | August 6, 2010 9:32 AM | Report abuse

Curious Citizen,

Good to know I'm not the only "paranoid" here ;).
The Noonan article does a good job of portraying the unease that many of us feel. America's Ruling Class -- And the Perils of Revolution by Angelo Codevilla at American Spectator: http://spectator.org/archives/2010/07/16/americas-ruling-class-and-the

is very detailed in his view of how we got here. It is extremely long but worth reading.


What I fear is that some "crisis" (manufactured or not) may prevent business as usual (elections) in the coming months.
I sure hope not, but at this point nothing would surprise me. We do seem to be in "Bizarro World".

Posted by: MOvoter | August 6, 2010 10:59 AM | Report abuse

So I guess you disagree with the 2008 Ezra. Awesome. Who needs principles?

Posted by: jarober | August 6, 2010 3:51 PM | Report abuse

Girly man pussy Klein gets taken to school:

Ezra Klein shows just how fresh and exciting the world can be if, for you, history began around 2000.

Exuding that aura of patchouli and devil-may-care insouciance that is catnip to lefties and irresistible to truly stupid women, Klein writes on the subject of the imminent fight in the next Congress over the fate of Obamacare.

put aside the obvious idiocy that the business community would be upset by a defunding of Obamacare and go to the core of the issue: that Congress refusing to fund programs that they don’t like is either dangerous or even new.

First and foremost, historically Congress has authorized programs it has never funded. Lobbyists know the pain of this daily. They struggle to have a project inserted in an authorization bill only to see it disappear from the appropriations. So the idea that projects and programs have to be funded just because there is an authorization for the programs is simply silly. Obamacare exists. We may, quite honestly, never have the votes or cojones to repeal it. But there is no requirement that Congress appropriate a single cent to implement it.

More recently, we’ve seen a Democratic Congress attempt to defund the war in Iraq. This war was legislatively authorized by the US Congress in 2002. This is a battle in which Klein explicitly endorsed efforts by the Dems to defund the war by forcing presidential vetoes of spending bills.

These types of controversies are a part and parcel of American political history. The SANE/Freeze movement sought to defund our nuclear weapons program. The Iran-Contra Affair was rooted in the Boland Amendment cutting funding for authorized intelligence and military operations in Central America. The Case-Church Amendment cut funding for authorized military operations in Southeast Asia.

Beyond the historical trivia there are two equally large points to be made. One philosophical and one practical.

Philosophically, democracies (or republics, if you will) do not function in an environment of “policy stability.” That is the province of monarchies and totalitarian regimes, though I can understand how Klein and a lot of other lefties could get confused on this issue considering the way they’ve toadied to Obama. But, like with the funding examples listed above, the left is really only interested in “policy stability” if their policies are in place. Otherwise, everything is up for grab. It is the sort of garden variety petty hypocrisy which really prevents any substantive dialog with the left.

Obamacare is a travesty that runs contrary to American tradition and it should be repealed. If we can’t muster the votes to repeal it — and this will entail overriding a veto — we can easily refuse to appropriate funds to implement it and we can prevent federal agencies from using staff to plan for it’s implementation.

Refusing to fund that program would be neither dangerous or even unusual

Posted by: kohnfjerry | August 6, 2010 7:08 PM | Report abuse

Klein, you're nothing but a LibDumb LeftLoone echo chamber. You don't understand why Republicans don't like the Comrade Obozo/Hairless Reid/Chairwoman Maolosi Communist Healthcare scam? I'll clue you in. It's unamerican. It tramples on individual freedom. You Left Wing Pinko Commies are trying to tell us how we must spend OUR money. That's extraordinary and revolutionary. It's also unconstitutional. With both Common Law and the 9th Amendment, gov't has NEVER had the power to dictate to people how they MUST spend their money for merely being alive. It's repulsive to any freedom loving person.

It's also scary how so many of you LibDumb LeftLoones freely and willing hand over your personal sovereignty in exchange for being "taken care of". I'll tell you this. They'll take care of you alright. About the same way Al Capone took care of people.

What the truth is is that you LibDumb LeftLoones make all these warm and fuzzy promises that sound real nice. The problem is the money just isn't there to pay for it, and you know it. That makes you not just liars, but 4kin liars!!!!

As for me, I'll take individual liberty of collectivism any day of the week. If you want it, go to Cuba.

VOTE REPUBLICAN!!!

Posted by: A1965bigdog | August 7, 2010 2:53 PM | Report abuse

Typoed. Meant individual liberty over collectivism.

Posted by: A1965bigdog | August 7, 2010 2:57 PM | Report abuse

VOTE REPUBLICAN -- if you think they will overturn the mandate, which was their own idea in the first place

VOTE REPUBLICAN -- if you are against bipartisanship, because they turned against a bill that is one-half their own ideas (including the mandate) to try to get back into power instead.

VOTE REPUBLICAN -- if you are against universal health coverage and you want to bring back rescission and denial.

VOTE REPUBLICAN -- if you don't want a non-profit public option to choose, because you don't want to save 5-7% on your healthcare insurance.

VOTE REPUBLICAN -- because they really haven't messed things up enough yet!

Posted by: Lee_A_Arnold | August 8, 2010 9:20 PM | Report abuse

As a former liberal and current moderate voter, I look for articles that are balanced and informative. Unfortunately, I'm reduced to reading at least two articles on any given issue; the liberal bias article and the conservative counterpart. In the current political climate, most news articles are thinly disguised pieces of political propaganda.

This article is a perfect example. Obviously it is meant to invalidate arguments from the right. The belief that all views from one political party are either benevolent or dysfunctional is to miss the culture of Washington completely. When a political party has a person so duped that he or she agrees with their agenda all the time then critical thinking and rational decisions have fallen to the wayside. It is time to stop the partisan attacks and bring back responsible government. Both parties and the reporters in their pockets should aspire to higher ideals. Ezra Klein's articles at times accomplish that lofty goal, however, this article is not such an example.

Posted by: tammyspears88 | August 9, 2010 11:30 AM | Report abuse

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