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Why it's so hard to pass health-care reform

Scott Brown’s victory in Massachusetts could be the end of the road for comprehensive health care legislation. If so, it would give a whole new meaning to President Obama’s address to a joint session of Congress last Sept. 9, in which he vowed that, although he was not the first President to seek universal health care, “I am determined to be the last.”

Everyone has his own explanation for the fact that the U.S. still doesn’t have a national health plan while all the other industrial democracies do. Here’s mine: The constitution.

I don’t mean that Obama’s plan, or any other, actually violates the constitution. Perhaps Congress lacks the authority to impose an individual mandate. Or perhaps not. I mean that the whole effort to create a new national health insurance system all at once flies in the face of this country’s quirky but durable 18th-century political structure. The Obama plan isn’t so much unconstitutional as it is counter-constitutional.

For better or worse, our founding document disfavors comprehensive national legislation of any kind -- let alone bills that seek to reconfigure 17 percent of the economy. This was intentional, of course. The Framers wanted to create a government that would protect the new country from foreign threats and foster trade among its constituent parts, but would not threaten liberty, which they defined as the freedom of individuals, states and localities to govern themselves.

To them, the main threat to liberty would come from the capture of the new political apparatus by a minority faction, or even by an overweening majority. So they built a system to play factions off one another: a bicameral legislature whose two Houses had different powers and were elected according to different principles of representation; frequent elections so that officials live in constant fear of public opinion; and a sharp separation of powers among the legislative, executive and judicial branches.

"While all authority in it will be derived from and dependent on the society,” James Madison memorably wrote of the new system, “the society itself will be broken into so many parts, interests and classes of citizens that the rights of individuals, or of the minority, will be in little danger from interested combinations of the majority."

In short, the Framers designed a federal government to make policy, when it did, that fit the lowest common denominator of regional, state, economic and other interests. This is very different from the national parliaments that rule Europe and Japan in a more centralized, majoritarian fashion.

To be sure, the Framers’ motives included protecting the “liberty” of Southerners to hold slaves. Nevertheless, their framework has endured unto this day. That is why Congress has so rarely even tried to enact a peacetime legislative package as sweeping as the current health proposal. The original Social Security and Medicare laws don’t even compare. The Kansas-Nebraska Act of 1854, which tried to fix slavery and secession once and for all, was pretty grandiose. But we all know how well that worked out. The American political system’s tilt against comprehensive national legislation, even in times of crisis, is the stuff of high school civics; in hindsight, it should have been more obvious to the men and women in the administration who staked so much on health-care reform.

“To see what is in front of one’s nose needs a constant struggle,” George Orwell wrote. But, he added, “sooner or later a false belief bumps up against solid reality, usually on a battlefield.” Or, in this case, at the ballot box.

By Charles Lane  | January 20, 2010; 3:17 PM ET
Categories:  Lane  | Tags:  Charles Lane  
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Interesting arguments, but what I'm not convinced of is that the Framers intended the system to be unable to pass comprehensive national legislation. Perhaps it only evolved that way because it's all the could get the various state delegations to agree to, because they were too concerned about loss of *state* liberties. After all, most of the states in the 18th century had pretty awful personal liberty standards.

Posted by: Section506 | January 20, 2010 4:11 PM | Report abuse

A minority faction has already captured the apparatus. They are called the Republican Party.

Posted by: chi-town | January 20, 2010 4:13 PM | Report abuse

I have an explanation that makes a lot more sens than this: too little knowledge and compassion among the electorate. Under the leadership of multi-millionaires with a lot at stake, people who can afford it the least are fighting health care reform the hardest. What a pity.

Posted by: gsross | January 20, 2010 5:29 PM | Report abuse

When discussing the Constitution one must remember that until the Civil War the States ruled the roost. In fact it was until after 1865 that the United States was called "the" United States. It was addressed as "those United States" and each state stood proud to take care of its own. One only has to remember that key federal poloticians and famous generals chose their sides based upon their home state many resigning from positions and returning to their States because their true allegents belonged more to the state than the Nation. In fact there was not a Congressionally mandated National flag before the Civil War, many Federal troops went into battle early in the war under different national flag designs. It was a different times but today our current health insurance infrastructure follows the "states" rule concept with each state supposed to regulate their own health insurance. So maybe some of our politicians and many of our media should sit down and study our history and see why things are the way they are before they simply state making serious changes. The current bills before our Congress pretty well not only ignore the will of the people but they pretty well ignore the American way. If they are going to change it they need to do some serious explaining why and how.

Posted by: staterighter | January 20, 2010 5:37 PM | Report abuse

I agree with gsgross, who said: "... too little knowledge and compassion among the electorate. Under the leadership of multi-millionaires with a lot at stake, people who can afford it the least are fighting health care reform the hardest. What a pity."
All day I have been thinking the problem comes down to either stupidity or selfishness. Greed, we will never solve. But education, I hope we can. A better educated, more informed public is the answer to addressing most every issue. Many of those who need healthcare reform the most have the poorest grasp and greatest fear of the proposed legislation. Then, the others, maybe not intentionally so selfish, are simply isolated and unaware of how problematic it can be for those less fortunate to find and/or have access to healthcare. The well-to-do cannot imagine that all people who work do not have health insurance. It does not occur to those who have always been provided for, that business owners struggle with the cost of providing coverage for staff when premiums increases by an amazing percent each year. Our experiences are just not common enough to allow for understanding.

Posted by: publicinterest | January 20, 2010 6:08 PM | Report abuse

Other than the Senate's twisting of the filibuster into the unconstitutional need for a supermajority to pass important legislation, I don't see what is so difficult about passing health care reform at a national level from a constitutional point of view.

It is true that getting a public option, and even more difficult, a single payer plan, was enormously difficult. But, was that because of the constitution, or because an electorate that does not know any better (they have never lived in Europe or Canada to see how much better systems work there) and a concerted effort by powerful vested interests, such pharmaceutical and insurance companies, to push back against the legislation? Maybe too, the lack of societal cohesiveness in a very diverse country of over $300 million people is an obstacle? In any case, I really doubt that the founding fathers wanted to make sure that people with pre-existing conditions cannot obtain health insurance or that huge numbers of medical bankruptcies characterize American life.

Posted by: AnonymousBE1 | January 20, 2010 6:33 PM | Report abuse

"The Framers wanted to create a government that would protect the new country from foreign threats and foster trade among its constituent parts, but would not threaten liberty, which they defined as the freedom of individuals, states and localities to govern themselves."

Oh forget the threat that the framers were MOST worried about...and after watching the election in Massachusetts that, thankfully, we're still worried over-reaching federal government that tramples the liberties of the people. That's why many oaths of office include the phrase " defend the Constitution of the United States against all enemies, foreign AND DOMESTIC...." The POS health reform bills trample the liberties of the people...they're not reform and they aren't about health. They are about government control.

The difference between you and conservative should have listened to us when we tried to tell you all that you think the Constitution is the problem. We think the Constitution is the salvation. Hopefully the tide is only beginning to rise that will sweep all the Alinsky and Zinn radical socialists out of Congress and back to the rocks they hide under. They almost had their fingers around the throat of the soul of America. They almost choked the life out of the real America. Now that the light of truth is shining on their goals, we can send their crazy ideas back into the dustb bin of history where they belong. All democrats in Congress out in 2010...all of them.

Posted by: PanhandleWilly | January 20, 2010 6:50 PM | Report abuse

Lane needs to go back and read a history book. The Kansas-Nebraska act did not try to permanently solve the issues of slavery and secession. The bill merely provided for popular sovereignty to decide whether slavery would be allowed in two territories. By repealing the Missouri compromise, the Kansas-Nebraska act led to the break-up of the Whig party, leading to the creation of the then mostly liberal Republican party.

Most of the founding fathers wrote the Constitution to create a moderately strong central government after the weak Articles of Confederation. They intended for the equivalent of an aristocracy to dominate the government, especially in how presidents and Senators were selected.

The Washington administration persuaded Congress to accept relatively sweeping, controversial, legislation to create a national bank and fund the national debt, as recommended by Hamilton.
The Republicans passed several major bills during the American civil war. The New Deal of the 1930's and Great Society of the mid 1960's were eras when Congress had little difficulty passing major legislation, transforming this country in major ways.

True health care reform is hard to achieve in this country because of selfish, greedy special interest groups who have undue influence over the political process. Presidents, their advisors, Senators and Representatives have their health care benefits, paid for by the people of this country. They generally seem complacent or indifferent about extending basic health care coverage to the rest of the people in this country.

Posted by: Aprogressiveindependent | January 20, 2010 7:21 PM | Report abuse

Yonkers, New York
20 January 2010

Probably the main reason the Congress finds it very hard if not practically impossible to pass health-care reform is that many of its powerful members accept significant amounts in political contributions from private health insurance companies on a quid pro quo basis and are thus compelled to place private interest over and above the national interest.

This is corruption pure and simple. The tragedy for the American people is that there is no way to stamp it out effectively.

Given the compelling need for one who runs for the Senate or the House of Representatives to acquire truckloads of money to finance a campaign, it is of course inevitable that candidates and vested interests cannot avoid entering into a conspiracy that has proved so harmful to the national interest.

Mariano Patalinjug

Posted by: MPatalinjug | January 20, 2010 7:44 PM | Report abuse

Which is why the approach should have been a federal bill to encourage healthcare reform at the state level.

Let states experiment. If voters want a state-wide single-payer plan, go for it. If voters want no plan for their state, that's OK, too. As is everything in between.

The federal bill should allow multiple states to collectively bargain (if they so choose) with health insurers and drug companies.

The federal bill can still include programs to identify and encourage implementation of "best practices".

Voters don't want to give more power to the feds. They feel they have little say over what happens in Washington. They correctly believe they have more of a voice in their state government. This is the way to do it.

Posted by: WylieD | January 20, 2010 8:00 PM | Report abuse

Oh gee, why IS it so hard? Maybe it's because a good part of the congress (the GOP)is bought off by the insurance and pharmaceutical industries? Or maybe it's because the American people are morons (even in MA). Or maybe it's both. Whatever the answer, don't anyone look to this clown (Lane) for the answer. He's just another half-wit toady for the JINSA/AIPAC gang.

Posted by: kurthunt | January 20, 2010 8:10 PM | Report abuse

The framers couldn't forsee the problems that their system created. Our current political system is completely, irreparable broken, and as a consequence the country is ungovernable. The founding fathers never took into account the concentration of power the corporations have attained, the power they exert on the media, or that the corporations could use money and favors to gain total control over Congress. Guess they figured that those elected to Congress would always be honest men, not crooks.

Posted by: Chagasman | January 20, 2010 8:32 PM | Report abuse

We as a people are very consistent. We love manias and bubbles. We have a predisposition against anybody acting to prevent our chance at wild success even though we deep down know that we will most likely wildly fail.

We didn't want anyone to tell us to not buy internet stocks during the bubble.

We didn't want anyone to rein in easy credit or actually give honest assessed value to our homes during the bubble.

We don't want anyone to change the runaway health care cost bubble either. "It'll wipe out a huge part of our economy!" "We are the world leader!"

Why do we never act to solve things before a full-blown crash? I think we as a people think that, while the system will crash eventually, we individually will end up better than most. When more hospitals that provide basic care are shuttered and costs skyrocket another 40% or so, we figure we will be okay, and it will be the other guy that gets hit.

We have the ultimate belief that we can manage to avoid catastrophe as we build the foundation for catastrophe.

Posted by: steveboyington | January 20, 2010 9:18 PM | Report abuse

"Maybe it's because a good part of the congress (the GOP)is bought off by the insurance and pharmaceutical industries? "

You're completely, 100% wrong.

The democrats hold supermajorities in both houses of congress and they have the presidency. The Republicans are irrelevant to the debate.

No, the real answer is that the Democrats, and the Democrats alone are too corrupt to fashion a bill that will pass, even amongst fellow democrats.

And I'll thank you to stop picking everybody's pocket to pay for your idea of compassion.


Posted by: Ombudsman1 | January 20, 2010 9:31 PM | Report abuse

After reading some of these comments I have come to the conclusion that all of these people stating that they are fighting for their "liberty" don't realize that they are really fighting for corporations to control their lives. Peel back the layers from all of these "grassroots" Tea Party orgs and you will find a laundry list of corporate interests funding them. They fall under the delusion that corporations are out there to make your life better. Sorry to tell you but they are out there to make their shareholders a profit. Our republic has now officially become a coporatocracy. You look at every piece of legislation and what is the first question that is asked: "How will this affect business?" It doesn't matter how many people will be positively affected by it, corporate interests rule. For all the talk about the Constitution, I beg anyone to tell me where the Constitution grants any rights/privileges to corporations. I believe it talks about "the people." While you're at it, please tell me the section where it states we must be 100% free-market.

I agree with steveboyington's comment. Nobody believes that anything catastrophic can happen to them until it does. Until they say, have a child with Type I diabetes and realize that child will be "uncoverable" for the rest of their life. In fact, the constitution does mention about providing for the general welfare of the people of the US. Mind telling me what freedom of speech or freedom of association one has when they do not have their health?

Posted by: bozzy | January 20, 2010 9:48 PM | Report abuse

Not to sound simplistic, but the Democrats have a clear majority in both houses of Congress - they don't need the Republicans.

However, polls show that between 60-70% of Americans don't want this. Should they use their clout to pass this bill, come the mid-term and 2012 elections, there wouldn't be enough Democrats left in Congress to fill more than a couple of limos.

Posted by: WestTexan2008 | January 20, 2010 10:26 PM | Report abuse

I agree with the author, and indeed the somwhat backhanded ensurance of individual and minority liberties is one of the most ingenious pieces of social engineering ever pulled off, and is indispensible to the greatness and long-term survival of the country. Unfortunately governments are not the only entities which can curtail liberty and victimize citizens, as we've seen before. The advent of trustbusting was the first battle on this field.
I, for one, didn't like this bill much to begin with, in particular the public option. It's not that I don't support universal access to good healthcare, it's that it wasn't a very good fix for the actual problem. There were glimmers that Obama, at least, got the point, in the very beginning, when he spoke grandly of changing the unfair practices of insurance companies. This is the next layer of the onion; that universally rising insurance premiums make healthcare unaffordable for many individuals and businesses. In this, the companies act as a monopoly, setting their own price for the only option on the market for anyone who wants to see a doctor.
The next layer down, though, may be more important, which is health care providers; in particular pharmaceutical corporations. These, again, charge prices that the whole market has no choice but to support; there are not really any options (generally, generic drugs are made under the same corporate umbrella as the originals).
It would be one thing if they were selling pizzas. You don't need pizza, nobody thinks that everyone has an inalienable right to pizza. If you can't afford it, oh well, have some Cheerios. But if there's a lowest common denominator of opinion on health care in this country, it's that health care, the right to life, is inalienable. I seem to recall something similar being stated in a very old document somewhere.
This is a moral issue, not simply an economic one. If it must be subject to the market, let it be regulated, bottom-up and top-down, in a simple, straightforward manner which allows access to all. This may come at the expense of some very very wealthy companies and individuals who may no longer be able to afford trade shows in Vegas. But, oh well, have some Cheerios.

Posted by: MGibbons1 | January 20, 2010 10:34 PM | Report abuse

I believe the citizenry have bought the bill of goods that the medical profession has peddled...we have the worlds best, don't screw it up. And the fact that they have no idea what real health care is available and should cost worldwide. lll informed people make dumb choices.

Posted by: trailcrawler | January 20, 2010 10:54 PM | Report abuse

Lane, Thank you so much for finally giving me an article that contained an educated viewpoint. While most in this administration wants to believe that the Constitution is a living document that can be changed for their whims, you have pointed out why it isn't!

I praise the Framers of our Constitution for thinking far beyond themselves and the times. They left Europe because of their socialist politics and created our Nation where Freedom rings, yet for some reason this administration forgets that we left there and became independent for a reason.

The Founding Fathers wanted Separation of Church and State and the healthcare legislation is a prime example of the Government overreaching its powers!!! Amen to you and thank you for such an educational read!

Posted by: groovgal | January 20, 2010 11:46 PM | Report abuse

Sounds like this guy wants to abolish social security and medicare too. The same arguments apply.

Posted by: hithere2 | January 21, 2010 12:43 AM | Report abuse

"Peel back the layers from all of these "grassroots" Tea Party orgs and you will find a laundry list of corporate interests funding them."

Prove it.

Posted by: 1100GS | January 21, 2010 1:02 AM | Report abuse

I agree with what you say, BUT we actually came within inches of doing this. The combination of the two bills that actually passed their respective houses was almost finished. Maybe within a day or two of final details being worked out. That is what makes this extra cruel. We DID manage to put together a winning coalition, no matter how flawed it was. And there was so much good stuff in the bill that never really made it into the public's mind. I feel sad beyond belief that we may not be able to go the extra few feet to get this done.

Posted by: LindaB1 | January 21, 2010 1:24 AM | Report abuse

”Peel back the layers from all of these "grassroots" Tea Party orgs and you will find a laundry list of corporate interests funding them."

Prove it.
Sure, why not.

From the FreedomWorks website:
“…we have been able to organize hundreds of Taxpayer Tea Parties across the country…”

FreedomWorks’ founder is corporate lobbyist and former Republican Congressman Dick Armey, whose former lobbying firm, DLA Piper, which he resigned from only in August 2009 five months after the first TeaParty rallies, represents Bristol Myers Squibb, among other pharmaceutical companies.

Among FreedomWorks funders: Exxon Mobil, Wal-Mart, MetLife Insurance, Philip Morris and foundations controlled by several prominent conservative families (i.e. think multi-millionaires).

Finally, the absurdly disproportionate coverage provided by FoxNews of TeaParty rallies is the equivalent of receiving from Roger Ailes hundreds of thousands of dollars (if not millions) of free advertising. But it’s even better than that because Fox’s coverage of the rallies is always presented to the viewing audience as “fair and balanced” reporting instead of the paid political advertisement it really is.

Don’t get me wrong on this last point about Fox, I agree that the TeaParty rallies are newsworthy events. I’m criticizing the outsized coverage, promotion, and participation in the rallies by FoxNews reporters and hosts. Did you happen to see Fox’s early coverage of the rallies in April 2009 when for a time the on-screen tagline actually labeled them as “FoxNews TeaParty Rallies”? That would be the definition of corporate sponsorship.

Posted by: Shadow9 | January 21, 2010 1:51 AM | Report abuse

The failure of health care is not due to our constitution. Come on. A comprehensive health care plan is an absolute slam dunk for our country. The failure thus far is NOT due to Republican opposition, but rather the greed of Democrats such and Ben Nelson. How can the middle class trust the ruling dem party when democratic senators are scrambling for their own self interests. Sorry, but the dems have shot themselves in the face at point blank range. I think the Republication platform is entirely selfish, but they are spot on winners in the Brown victory. It amazes how so many people who stand to benefit so much get lost in lobbying and special interests. The dems look like the Scarecrow in the way they try to govern. "If I only had a brain." I am embarrassed to be a dem at this point.

Posted by: citizen4truth1 | January 21, 2010 2:14 AM | Report abuse

I do not believe that health care reform has actually failed. I believe that a smaller, much more insurance company friendly bill will eventually be signed.

Of course Obama will be pilloried, as will most of the democratic party. Any attempt at solving our countries problems involves great risk because the moneyed interests invested in the status quo do everything they can to oppose it.

Make no mistake. Out health care system needs reform. We pay too much money for too little results. This isn't a matter of opinion. Based on any measurement chosen, health outcomes, cost of care, access to doctors of ones own choosing, time spent waiting for care, time it takes to get reimbursement for care, etc, most democracies in the world do MUCH better.

America today is one of the more socialized systems around. Many advanced democracies have no equivalent to Medicare or Medicaid, or any type of government controlled care. Those systems are completely controlled, 100%, by private insurance. No public hospitals, no public health care of ANY sort.

Yet, somehow the American public has been sold a bill of goods by greedy politicians with no interest or compassion for the common good of our great republic. By seeking only the failure of our government attempting to solve the many problems we face, they hope to advance their own political interests.

If you doubt what I say, simply do a little investigation on your own. Look for comparison studies between health care systems in America and other developed democracies in the world. Look at what your favored leaders are actually saying about their political strategy quite openly. Listen carefully to the spokesman of the Republican party. And lastly, ask yourselves truly... do you actually believe that the motivation behind Obama's actions and policies are anti-american? Keep in mind that if Obama and his party fails, then future generations will have forever to judge him and he will not be re-elected, both results that are clearly against his own self interest.

I hated George Bush and his policies. I detested his wars and his blindness. I was enraged by his lack of respect for the constitution and the values that make America great. But never, a single time, did I believe, or did I ever hear that anyone in power believed, that he was anti-american, or against America in any way. Nor did I ever ascribe his motives to being an evil man or trying to do anyone in America harm.

So this hatred of Obama, and willingness to demonize him is startling to me. I have to put a lot of it down to racism, and personal dislike. But still, to think that an American President would work against his own self interest in order to make America fail qualifies the ideas originator for either the loony bin.

Posted by: reussere | January 21, 2010 3:09 AM | Report abuse

Surely you know that the Framers didn't have the motive of protecting the "liberty" of Southerners to own slaves. At the time of the ratification, slavery was legal in most of the North was well, including Massachusetts and New York. At the time of the Emancipation, slavery was still legal in, among Northern states, Maryland, Delaware, and Kentucky, as well as the District of Columbia. Lincoln's "proclamation" did not free the slaves in the North, only in the Southern states.

I know this doesn't square with the South = Evil narrative, but facts are facts.

Posted by: otismcwrong | January 21, 2010 3:16 AM | Report abuse

The difficulty is obvious and it isn't rocket science. The biggest insurance companies are owned by the Banking Families that own the FED. concerning ownership of the FED, see :

Charging ten times more that I pay here in Europe for health insurance, the companies are harvesting trillions for the FED Families. (Rockefellers, Goldman Sachs, Rothschilds, etc.)

The Banks and the Insurance Companies OWN both the Republicans and the Democrats. Naturally, the profits of the Insurance Companies and the Banking Cartel Families are NOT going to be lowered.

So, no single payer or public option.

Why are the American People against the legislation? No Single Payer, which is what the majority of us wish to have.

Who gets voted out next? Well, I have a list of all the Senators and Congressmen from California who voted for the Bailouts and other money that went to the Banking Cartel Families, and the companies they own, such as GM.

These next elections, out they go, and if I could find a Communist or a Socialist on the California Ballot I would vote for him or her immediately and certainly for anyone who campaigns to close the FED and jail the FED families, and ALL their lackey politicos, such as Boxer and Pelosi.

Posted by: vcompton1 | January 21, 2010 6:10 AM | Report abuse

"In short, the Framers designed a federal government to make policy, when it did, that fit the lowest common denominator."

Similarly, over the past couple of decades WaPo has redesigned itself for the lowest commen denominator of reader, which explains why Charles Lane has a job.

Posted by: misterjrthed | January 21, 2010 6:47 AM | Report abuse

Why,becouse like social security people must die early for the numbers to plug into the cbo's socket.The system was not a problem till gov and aarp voters were able to augment their retirement packages with a form of welfare for the comfortable.We will need to tell the truth about these fraudulent vote buying bills that will break us as the babyboomers decend on all programs.TRUTH PAINFULL

Posted by: jmounday | January 21, 2010 7:23 AM | Report abuse

A very interesting discussion. However, I might suggest that with everything in DC, we overthink and assume some sort of intellectual arrogance of what's best for people. I think most of the ground swell against the current legislation has little to do with Big business (Insurance or Pharmacuticals) and more about pocketbook issues. To strengthen this argument, how did Reid "buy off" the Nebraska and Louisianna Senators...exempt/payoff their States increased costs which are not calculated as part of the $900 Billion proposal. The Idiot" American Public know how to balance their checkbooks. They could see that this Legislation didn't pay for itself. Right here in Virginia, the legislature is trying to figure out how to cut services to balance the budget. This legislation would add $30-50 Million/yr of Medicaid increases to that budget (again not included in the Administrations numbers). The Independents in Mass are neither Republican nor Democrats, they are people who have to pay as you go. Washington takes them for granted.

The intellectual question of note in the article is who should be protecting the "minority". The arrougance in Washington is that "Big Brother" knows best. This attitude is why most Americans have had little respect for Congress (Republican or Democratic) for years with approval ratins never gettting out of the 30's. I would enjoin the Washington establishment to stop drinking it's own Koolaid.

Posted by: rhino2 | January 21, 2010 7:31 AM | Report abuse

Yes, please push harder for health care. Accelerate the Democrat losses in November. Now is the time to double down on OUR efforts to elect more conservatives to Congress and the Senate. While the people have spoken, it is not time to get complacent. The perfect storm of war fatigue and a wounded economy, mostly brought on by democrats is the only reason for the election results of 2006 and 2008. November 2, 2010 will mark the death of progressivism – permanently. They people have seen it, and not only don’t like it, they are fearful of it. This is not how the founding fathers envisioned America. They founded America to get away from the socialism of Europe. They don’t want to live in a welfare state. They want accountability from their politicians. They want a fair value for their tax dollars, not bribes, pork, and payoffs.

Posted by: theillinoisguy | January 21, 2010 7:40 AM | Report abuse

Health care legislation doesn't have to be an all or nothing solution.

It's just being created that way because a few extremist Democrats like taking from the middle class, giving to the poor, and ensuring a profit for the special interests.

Stop the nonsense, propose some good legislation that cuts costs for 80% of Americans without specifically providing benefits to your backroom buddies, and you'll be able to pass some reforms.

Posted by: postfan1 | January 21, 2010 8:20 AM | Report abuse

The real reason we have such a mess in health care is because of the effing insurance companies. When are you morons going to wake up? They make $$gazillions, and you work you asz off with little prospect of getting affordable, effective care. Just wait until you lose your job, have to pay your own premiums, and the effing insurance company tells you it won't cover the treatment to save your daughter from a painful and prolonged death from some kind of heinous cancer.

Posted by: adrienne_najjar | January 21, 2010 8:29 AM | Report abuse

The irony of the present realities of the match between our governmental system and its constitutional foundation and our pluralistic highly diverse "body politic" is clear enough. At the very time that political liberals addicted to the use of governmental power call for its use in sweeping, centralized and uniform ways, others of liberal leaning in the culture at large are calling upon us to embrace diversity. It is very difficult to reconcile these positions. A strong national government with a writ that runs large does not fit a very diverse society and economy very well. A federal system that leaves much room for change by states is much better suited to such a society.

Posted by: jweley | January 21, 2010 8:58 AM | Report abuse

Mr. Lane, your argument doesn't hold water. The predominant reason for allowing the states to have power was to protect the institution of slavery. The founders--not gods but seriously compromised compromisers--were able to to tolerate Hamilton's arguments for a national bank. The interstate commerce clause has from the beginning been used to curtail states, and even business owners (e.g. segregated hotels during the civil rights movement). But most importantly the bicameral congress, and the tripartite government, permits us to vote for or against comprehensive legislation of all sorts, including health care. This is not about the police power of the states. It's about just allocation of liberties and access to key political institutions. Read Norm Daniels' Rawlsian justification for universal access to health care. It is deeply American, Mr. lane, and you should be informing your readers of the important moral arguments for just health care. Instead you pretend this current disaster is about liberty. Health care is a necessary condition of liberty. You know that, so why not tell your readers.

Posted by: douard1 | January 21, 2010 9:16 AM | Report abuse

Good points.

But the Constitution was written before a cure for polio, before aspirin, before penicillin or open heart surgery.

The founders never even contemplated modern medicine, or a health care system.

The founders were worried about abuse of government authority. The Patriot Act, FBI spying, these issues would have greatly alarmed many of the founders. But there is no national debate. Ironic.

The constitution allows for the government to take care of the general welfare of the people. And if national health care runs afoul of the constitution, there is a provision for amendments.

We may not want national health care, we many cite the constitution not to implement it. The current health care system is damaging the private business sector. China just clocked around 9% growth. India is growing. They don't care about the constitution, corporations don't either. Our competitors will strive on.

We can wait, we can do nothing, and such a change to national health care could be worse. But we are not assured the top economic spot in the world, nor the standard of living that many are accustomed to.

Certainly we don't want to give the government abusive authority, (and medicare hasn't usurped the Bill of Rights, at least not yet), but we don't want to be waiving a 200 year old documents from our houses in a 3rd rate country.

Posted by: camasca | January 21, 2010 9:17 AM | Report abuse

Illinoisguy put it well. If that succinct post went over your liberal heads, let's just say the failure to confiscate the private healthcare industry has been the people's outspoken refusal to be victims of further oppression and outright theft by the democrat administration and congressional majority.

If that's too complicated for you, there is also, "Your hands out of our pockets."

Got that?

Posted by: reader90 | January 21, 2010 9:22 AM | Report abuse

I agree in one sense. The Constitution designed a legislature with one house that represents the people (House) and one that represents the states (Senate). The result is that conservative states with few people like Alaska and Wyoming have two Senate votes the same as more progressive states with many people like New York or California. One only has to compare the House bill to the Senate bill to see what the majority of people want. (Or at least what they wanted last summer before a billion dollars of insurance company lies were broadcast nationwide.)

Posted by: SC_observer | January 21, 2010 9:58 AM | Report abuse

I suppose that to our modern day "liberals" (who are in fact the very opposite of that term derived from liberty), the Constitution must indeed seem "quirky." How quaint that the system tries to balance off factions to protect the liberty of the citizens from the relentless power grab of the ruling majority. Growing frustrated with constitutional checks and balances which no one bothered to teach them about in civics classes, they tried to pack the court in FDR's time, called to abolish the electoral college (after 2000) and now the filibuster. Nothing should stand in their way of "providing" us with a centralized "health care" bureaucracy we don't want paid for with our own money.

It also never seems to occur to our elite liberal friends that the institutions of government will not forever be under their control, and that constitutional balances once eliminated might then not be available to protect them from a future administration hostile to their interests.

Franklin said that he and the others gave us a Republic, "if we can keep it."Fortunately, the American people still respect and value the Constitution, even as our elected officials sworn to defend and uphold it routinely ignore it instead. The people of Massachusetts, cradle of our liberty, have spoken again, as they did at Concord bridge in April, 1775, when they fired the first shot heard round the world.

Enough is enough. Stop bribing us with our own money. We want a limited government that lives within its means and respects the Constitution. Listen up now, or go the way of Martha Coakley in November.

Posted by: blackmage | January 21, 2010 10:08 AM | Report abuse

Illinoisguy wrote that

"The founding fathers....founded America to get away from the socialism of Europe. They don’t want to live in a welfare state."

WHAT?!?! King George II was a socialist??? He presided over a welfare kingdom, I mean, state? Holy !#%#$@!

If that was a joke, and it had to be, then why did reader90 praise him for what he wrote? That's just weird.

Posted by: Shadow9 | January 21, 2010 10:12 AM | Report abuse

So you are saying that the founding fathers wanted a government of the special interests, by the special interests and for the special intersts? It is interesting how quickly you dismiss slavery. Also, to suggest that health care reform is bigger than Social Security and Medicare is just plain wrong. We are required to have auto insurance, pay into Social Security and Medicare, fund various public programs, and register for the draft. This is clearly an infringement on our liberties. Society can not function with everyone just looking out for their own selfish needs. That mindset is surely the basis for an unraveling of our nation.

Posted by: cdierd1944 | January 21, 2010 10:12 AM | Report abuse

This is the rankest nonsense, of a sort we've become accustomed to from Lane.

The pending healthcare reform legislation pales in scope and size in comparison to the comprehensive program of New Deal legislation enacted between 1933 and 1936 that radically overhauled 100% of the national economy, not the mere 17% affected by healthcare reform. It is the most shameless sophistry for Lane to compare the present legislation to Social Security while ignoring New Deal legislation that gave birth to vast federal regulation of the banking and securities industries, created the framework for modern labor relations (and large, national unions), guarantied bank deposits, regulated prices and production standards, and generally revolutionized the relationship between government and commerce.

For Lane's information, the constitutional issues relating to this massive intrusion of government into the economy were fully resolved by 1937, with the Supreme Court finding that these powers were constitutional. Arguments, like Lane's that these powers were somehow offensive to the constitution were roundly rejected, and these arguments have not received serious judicial consideration in the intervening 70+ years.

Lane's ignorance of the constitution and the history of judicial interpretation of the economic and regulatory powers of the federal government is painfully obvious. You could take the present healthcare legislation and expand it 50 fold and it would not begin to approach the scope of the New Deal legislation in terms of the expansion of federal power or impact on the national economy.

Posted by: cassidyt | January 21, 2010 10:13 AM | Report abuse

how much over-analizing can you folks do?

MA has health care!

it's not that they don't want the rest of the country to have the access to the care they have - it is simply that the good folks in MA want each and every state to fashion their own health care rules.

on a national level - the are a few things that need to get done - that most of us can agree on -
universal medical and financial record keeping sysytem.
national health education.
elliminate coverage exclusion and removal due to new or existing medical conditions.
medical tort reform.
protection from medical bankruptcy.
tuition relief for those choosing to serve as GP's in underserved/impoverished areas.
severe punishment and fund recovery statutes for those providers who attempt to defraud the system.
mandate living wills to gain entry into medicare.

start there - the record keeping systems alone will begin saving money and lives from day 1. health education will begin to make us a healthier nation and immediately begin to lower long term costs.

Posted by: boblesch | January 21, 2010 10:14 AM | Report abuse

Thank you for providing this much-needed constitutional framework. The individual mandate may have looked good in theory, but in practice it would have been repugnant to our founding values. The same is true for the proposed premium subsidies, which would have created a de facto welfare state.
What the framers didn't envision and is a true problem of modern politics is the undue influence of corporate interests. They are too powerful to be ignored, and are in fact Too Big to Flail.

Posted by: mtpeaks | January 21, 2010 10:17 AM | Report abuse

I too agree with Illinoisguy. The greatest threat to our nation is from within. Today that threat is represented by those who see our constitution as confining rather than liberating. The true secret of our continuing success is our constitutions guarantee of individual liberty and opportunity. Those guarantees are protect all of us (business owners too).

Posted by: Horrido | January 21, 2010 10:20 AM | Report abuse

It seems that many of the commentators are missing the author's point that passing large bills that affect the entire nation in one, grand sweep is _structurally_ very hard to do.

The United States was -- and still is -- a federation of independent states. The fact of our federation is codified both in our legal documents such as the Constitution, but, more importantly, in the way we've actually run the country for more than 200 years.

Consider the fact that we have 50 separate state legislatures, with 50 separate court systems, operating under 50 different state constitutions. We are not structured to have these huge, national bills thrust upon us. It doesn't fit easily. That's the author's point, and one well taken, I think.

The US health care system is often compared to other European countries, but structurally, the US is much closer to the European Union than it is to any single country. 1 EU Country = 1 US State.

Does the EU have universal health care that applies equally to every country in the union? Absolutely not; every country rolls its own. That's the way we do it here in the US, too: every State rolls its own.

This is actually a source of great strength. It lets a state such as Massachusetts experiment with universal health care without having to argue with Texas about it.

Independence and loosely coupled federation is an excellent structural principle for any complex system. You see it repeated all through nature in biology, in building architecture, in complex machinery and systems such as software applications.

The Founders knew what they were doing.

Posted by: dmarney | January 21, 2010 10:22 AM | Report abuse

Not so much a comment on your analysis than a comment on constitutionalist rhetoric. You write of the framers of the constitution as if it were some large party of political philosophers debating, rationally, over some overarching vision for the country. At best, they were reasonably savvy politicians who were trying desperately to hammer out a compromise document that would bring 13 newly minted states together and keep the former colonial power at bay. That their compromises that yielded today's constitution are at all meaningful or even useful today is debatable. That the document was a success is equally debatable. It didn't prove a success if you were African, a woman or an Indian. It didn't prove very useful in helping to address the tensions between north and south. And as you now point out it hasn't proven to be very effective in providing the basis for Americans to address real and pressing problems of the modern age.

Posted by: atidwell | January 21, 2010 10:23 AM | Report abuse

Ah, the Constitution! So that's the problem. Thanks for the info! So, who pays for this info-commercial?

Posted by: rusty3 | January 21, 2010 10:25 AM | Report abuse

Ah, the Constitution! So that's the solution. Thanks for the info! So, who pays for this info-commercial?

Posted by: atidwell | January 21, 2010 10:28 AM | Report abuse

You are terribly wrong. It would be quite easy to pass health care reform and the legislature should try some time. Right now there is not any reform in the current bill with the exception of the "pre-existing condition". A strong, well planned reform that addressed the issues and did not simply provide for another great, inefficienct government social program for buying votes would be a good start. Issues addressing what causes the high cost, such as tort reform (malpractice insurance and court awards); government investment in high-risk medical technology and pharmacudical research and development; better funding of eligible and qualified students who would accept a requirement to work where they are most needed for say 6-8 years after graduation; and finally address the issue of States rights in the regulation of health insurance. The Federal government needs to show an effort to eliminate Medicare and Medicade fraud and it should look at a Federal program that was designed for those that cannot afford health insurance. It needs to be a graduated well thought out plan, not simply the liberal concept of standing up putting its hands in working Americans' pockets and throwing money at the problem. The Federal plans for education have proven that simply throwing money at it solves nothing.

Posted by: staterighter | January 21, 2010 10:29 AM | Report abuse

Liberals are idiots.

The constitution isn't the issue here. The healthcare bill isn't proceeding because it's garbage. It's unbelievably expensive, completely incomprehensible, not universal, opposed by a clear majority of the electorate, does nothing to contain costs, was intentionally written in secret to prevent congress and the people from knowing what's in it, and completely exempts or bribes massive groups (which means screwing non-union, non-amish, non-Nebraskans, etc) in order to get it passed. This turd is unpolishable. It sucks, and We The People know it.

Dump it and start over. Or better yet, start working on problems that people give a carp about, not invented crises intended to put President Zero's arrogant mug in history books.

Posted by: HypnoToad | January 21, 2010 10:33 AM | Report abuse

i live in texas and not to belabor a point i am in a minority, white in a state that will be 65% tejano in two or three years. texas will never have any kind of health care because the teabagging racist like rick perry would never vote to give minorities of any color or creed a chance at a decent life.the only hope i have is the power of the federal government to step in to balance the natural desire of rich hillbilly scum to exploit anything and everything in the name of the holy dollar. money is more important than people. my only existence is to be the wage slave of some corporation.the republican philosophy summed up in twenty words or less.

Posted by: trjohnson8890122 | January 21, 2010 10:33 AM | Report abuse

This is just silly. State's rights. Like I'm going to get a better deal out of Richmond or Sacramento.

Posted by: atidwell | January 21, 2010 10:34 AM | Report abuse

Healthcare insurance is an example of a type of good (much like any insurance) that you don't feel the need for it until you run into a problem. An added complication is that some segments of the population (such as the young) are less prone to expensive health problems than others, unlike car insurance. Consequently, the less risk-prone populations are going to view a mandate as an infringement on their personal liberty unless they are made to understand why this is necessary. It is necessary because there is still a positive chance anybody will have catastrophic medical expenses at any time - and the uninsured persons cannot be turned away because of moral reasons. The past approach has been to pass along such unpaid expenses from the uninsured to those with insurance or those with ability to pay by inflating costs of all health services. Thus, a mandate is fairer. As the costs go up, more and more people will choose to not buy insurance thus further increasing the costs to those choosing to insure. It is only through universal mandate can costs be better distributed and kept down. Of course, if you are someone who never needed such expenses, you would have overpaid with a universal mandate, but you never know beforehand. As you can see, this is a complex message to convey to people. Perhaps this is one reason that Obama has not tried to communicate this extensively - I think he was waiting for the plan to be wrapped up so that he can explain to the American people. This turned out to be a strategic error.

Bottom line, the issue may be a matter of communication and not entirely an issue of infringing individual liberties. For example, car insurance is an area, people have accepted universal mandates (provided you have a car) although they limit your individual freedom. I think people need to be educated that mandated insurance is ultimately fairer, because any unplanned expenses for the uninsured is being currently picked up by the insured.

- which is an area where there is an insurance manadate - where the perceived risk of an accident

Posted by: jmiller6 | January 21, 2010 10:49 AM | Report abuse

*The current bills before our Congress pretty well not only ignore the will of the people but they pretty well ignore the American way*

Gotta love all these people who claim to speak for "We the People" or to be defenders of "The American Way" as though either of those things were monolithic and easily knowable. What about all of the Americans who disagree with you (it generally runs between 35 and 55 percent, depending on the national mood)? Are they any less American than you are?

And if your answer is yes, what do you propose to do about that?

Posted by: crblaisd | January 21, 2010 10:50 AM | Report abuse

Sounds like a misquote of Orwell. As I recall, (referring to 2+2 being 5 not 4,) that it is a constant struggle to NOT SEE what is in front of one's own eyes. Or to put it another way, to avoid thought crime.

What's in front of our eyes in this article is that The Constitution needs some improvement. Think that!

Posted by: AIPACiswar | January 21, 2010 10:51 AM | Report abuse

Government(G) created this problem by disrupting the workings of the free market.
Step 1 : G bans wage increases during WW2, so companies offer paid health insurance to attract workers.
Step 2 : Health insurance paid for by employers fosters a disconnect in the public between the cost of Health Care (HC) and its benefits, after all its paid for by employers, so health costs rise.
Step 3 : HC costs rise so much that the old folks who are not employed can't afford health care, so Medicare is created by G to win votes and pay for them. More disconnect from the costs of HC since G is picking up the costs.
Step 4 : 40 years of G paying for HC for the poor and elderly results in an explosion of costs for medical care. No medical facility or doctor can offer reduced benefits or they will get sued by Trial Lawyers in a system set up by the G. Only the best for everyone with the costs hidden behind work benefits or the G picking up the tab.
Step 5 : HC costs are so high that no one, even the G, can afford it! ObamaCare is an effort to wring yet more $ from the system for HC for potential Democrat voters. Most of this $ of course, would come by selling bonds to the Chinese !
Friends, we have to quit this fraud. We have disconnected HC from the market with really very predictable results.

Posted by: bebgsurg | January 21, 2010 10:54 AM | Report abuse

*All democrats in Congress out in 2010...all of them.*

Because it was so much better under all Republican rule. It's just another swing of the pendulum; your beloved Republicans will continue blowing Wall Street bankers and robbing you blind. All your impotent rage and angrily cast votes won't change a damn thing.

Posted by: crblaisd | January 21, 2010 10:55 AM | Report abuse

Health insurance reform is a dead issue, especially now that the Supreme Court will allow corporations to spend whatever they want to influence elections. You can forget any legislative initiative that will benefit the average joe. it's all for the rich and the big corporations now. that's who really runs the country. the rest of us are just being manipulated by the powerful into thinking we have a say.

truth be told, most people really don't care about making health insurance accessible to others as long as they have their own and feel secure that they will always have it. the idea of shared sacrifice and compassion for your fellow citizen is not longer valid in the united states. we can about no one but ourselves.

the best advice i can give to anyone is make darn sure you do anything and everything to say employed and be employed with a company that provides health insurance benefits. otherwise you are own your own and no one, NO ONE, is going to give a damn about you and your problems.

sure, they may toss a few bucks into the red kettle at christmas time, or send a text message through their cell phone to donate $5 to help the victims of a flood or earthquake. but make a sacrifice to help 40 million people in the united states? fagedaboutit.

Sad to say, but that's what our country has become.

Posted by: dlpetersdc | January 21, 2010 11:00 AM | Report abuse

Mis Amigos the Constitution was written and deliberated on by a group of non selfish men who wanted their liberty perpetuated and for future generations to be able to enjoy liberty as well. Health Care is not in the Constitution by any stretch of the imagination. If Democrats wanted to promote a change in the Health Care system they should have started with simple inguiries such as Tort Reform, Insurance and Pharmaceutical practices. Why did they go in and rewrite an entire bill. For what purpose. Mis Amigoes they are greedy and want the power. A Socialist Dictatorship that they all think they will be involved with. But I don't think it will work out that way. Vive Los Estados Unitos!!!!!

Posted by: pechins | January 21, 2010 11:03 AM | Report abuse

Everybody likes to point out that: "The United States is the ONLY IDUSTRIALIZED NATION without National Health Care."
Yeah. What's your point? We're also the ONLY INDUSTRIALIZED NATION with a MILITARY. Yet I don't see these, same people, clamoring for those countries to BEEF UP their Armed Forces.
They also fail to mention, that these 'Other Countries' contribute SQUAT, to the MEDICAL WELL BEING of the WORLD. NO New Discoveries. No Medical Breakthroughs. No New Procedures. No New Medical Technologies. And No NEW LIFE SAVING DRUGS.
I know of NO-ONE leaving this country, because they can get BETTER TREATMENT someplace else. NO-ONE.
Am I getting through to you morons?

Posted by: GoomyGommy | January 21, 2010 11:03 AM | Report abuse

The republicans who say that they want to scrap the current health care bill and start fresh to develop plan that really cuts costs is a complete load of bull. Total spin. Have you seen the repub version of the health bill? Of course not, one does not exist. The repubs are completely in bed with corporate america and the last thing they want is cost control. Our beloved congressmen are getting kickbacks for their "NO" votes. Perhaps not in direct cash payments, but certainly for favorable campaign contributions and perks through untraceable pacs. Why does business invest so much $$$ in tv advertising? Because it works. So, corporations invest heavily in media propaganda against reform and it works, too. The goal of the subsidized media spin is to make it appear one party is fighting for "you" on pocket book issues, while clearly they are protecting their own self interests and perks. Unfortunately, the dems are also exceptionally greedy and cannot rally around a good idea and pass universal health care at low cost to our citizens because they are also idiots. Neither side has credibility. Very sad. And we wonder why young people get so turned off by politics. People are now turned off to the health care bill because of all the public temper tantrums of democratic senators, labor unions and insurance companies. Every time one of them screamed foul ball, concessions were made for millions of dollars at the expense of coverage and cost control and sensibility. How can one have faith and trust in that kind of legislation? It makes you want to throw up.

Posted by: citizen4truth1 | January 21, 2010 11:05 AM | Report abuse

This take is very interesting. I am with, and we wrote about this topic on our website today:

Posted by: kbullard | January 21, 2010 11:15 AM | Report abuse

The framers could not foresee the modern global economy. The model that the Chinese are using is more akin to that of an American corporation, with a board of directors and a CEO running a focused business with long-range goals. They also have a huge, money-motivated, hard-working, and non-unionized workforce. We like to think that we are more innovative than other countries, and perhaps, at the margins, we are. But unless we decide that we are true patriots, willing to compromise for the good of the country rather than our individual desires, the U.S.A. is destined to go down, down, down.

Posted by: windroad | January 21, 2010 11:17 AM | Report abuse

This is one of the dumbest article I have read on health care or policy making in general. These are the kind of people writing for this establishment tabloid to brainwash the public that is their main objective.

Posted by: kevin1231 | January 21, 2010 11:18 AM | Report abuse

The issue with people considering health care a right is that you cannot consider anything that requires someone else to do something for you a right.

The problem with modern liberal thinking is that they believe collective rights exist when they don't.

The only rights that exist are individual rights and health care cannot be considered, by definition, an individual right.

Posted by: BradG | January 21, 2010 11:28 AM | Report abuse

So much leftist drivel on here that its hardly worth responding. If you 1) hate private sector profits 2) hate the idea of a society based on merit and 3) are hell-bent on forcing your ideals of social utopia on everyone around i've got news for you: the U.S. probably isn't for you!

Posted by: tab1 | January 21, 2010 11:31 AM | Report abuse

The reason people are so resistant to health care is that 80% of us will see the cost of our care go up and quality go down under the plans that the democrats have decided to ram up our gazoos because they think they know better. Well the fact is no has actually sat down and tried to find out why things cost so much. They blame the insurance companies for making so much money but the fact is they don't make a large proffit but the democrats have made it popular to vilify them. What people don't realize is that just as oil the biggest profits are made by the government through the collection of taxes which represent at least 30% of the cost and overburdensome regulation which accounts for another 10% plus the unholy alliance the democrats have with the trial lawyers which accounts for another 10%. But you don't see them reducing taxes on health care, streamlining regulation or putting tort reform in place do you?

This whole health care reform has nothing to do with improving the quality of care or reducing costs. It is all about controlling an aspect of society. The people are sick and tired of government constantly interfering in their lives with new laws, fees and telling them what they can and cannot say. That is the real message of Tuesday's election.

Posted by: Pilot1 | January 21, 2010 11:32 AM | Report abuse


A search the the Thomas database ( will prove you statement false.

Please start researching your statements before making them. The republicans in congress have made several attempts at Health Care Legislation. The Democrats, being in power, have said no to all of them so far and then denied that they were ever presented.

The truth is out there in the public record and not from the mouths of our representatives.

Posted by: BradG | January 21, 2010 11:33 AM | Report abuse

Individual mandate. A give away to the Insurance industry.

If I can't afford to see a doctor now, then madating I buy insurance, which I then could not use, because all my funding is being used to pay insurance, who co-payment is then more than I have left over, plus the cost of prescriptions , isn't reform. It's an insurmountable burden which would keep me from seeking treatment.

Posted by: maxtor0 | January 21, 2010 11:36 AM | Report abuse

The reason this bill was so unpopular is because 87% of the citizenry already has insurance and the bill didn't offer a compelling reason for them to give up what they have for something they didn't want. I think that 87% would support a bill providing national health care if they had any confidence that the new system would not completely balloon out of cost. My 99 year old father was in the initial 1936 class of social security contributors. When he retired in 1972, he got back everything he had put in, compensating for inflation, in the first eight months. After that, he drew on FICA contributions from his fellow citizens that were still working. Medicare and Medicaid were similarly underfunded and built on fiscal pillars of sand. All three programs are coming apart at the seams and heading for insolvency in the near future. That is why the 87% didn't want to turn over their health care to the Feds. The Feds have shown over and over that any politician-controlled entitlement program will be under-funded and go broke. Does any believe the promoters of this legislation about the projected costs? Every national health care system on earth has addressed two central issues: 1. limits on medical liability. 2. rationing of care. Neither party will address these two fundamental aspects of national health care; go to Germany, England, Canada, or wherever. Their systems function, but the lawyers are mightily excluded from meddling with the system and the care is tightly rationed. Then, and only then, will be able to afford national health care in this country.

Posted by: kmsbears | January 21, 2010 11:40 AM | Report abuse

@publicinterest and gsross - "lack of knowledge and compassion" misses the point entirely. The rich can buy themselves freedom, the middleclass know that their freedom once taken will be gone for good. This is the reason why the middleclass are less willing to sell that liberty for a few years of health care. The poor on the other hand often don't feel they have effective freedom anyway - justifiably.

About other (eg. European) systems. Those systems in general would not function in an environment as individualistic as ours. eg You would not find support anywhere in Europe for the idea that an unmarried woman has a right to have as many children as she wants regardless of her ability to support them and the government is required to make up the difference. That sort of attitude isn't common here, but it has enough ideological support here to destroy the system.

Posted by: mnemos | January 21, 2010 11:43 AM | Report abuse

gsross and steve boyington were all over it early in the thread - the electorate is lazy and wilfully stupid, doesn't bother to investigate if candidates' records suggest they are telling the truth and chooses to believe policies and initiatives assessed to be unsustainable by experts will in fact go on unabated. The housing bubble, which staggered on for a good six to eight months longer than should have been possible, was kept alive by greed on the part of one element and stupidity on the other.

Far-right zealots are every bit the crybabies everyone else is when the bottom falls out of their let-the-markets-regulate-themselves, eff-you-Jack-I-got-mine world. They quack loudest in defense of keeping things the way they are only so long as such a policy spells personal success and satisfaction. That's why they make the worst leaders - because they care only about themselves and their immediate peer circle.

The most generous country on the planet is also home to the most selfish people.

Posted by: marknesop | January 21, 2010 11:50 AM | Report abuse

The health care debacle has more to do with four of the deadly sins: Extravagance, Greed, Pride and Narcissism.

The biggest constitutional dilemma is that we have too many states with tiny populations. This gives their senators far more power than they deserve.

The only way out of this dilemma is to combine states with less than 4 million people. North Dakota has 641,481 people. South Dakota has 804,194 people. Rhode Island has 1,050,788 people, less than many cities.

Posted by: alance | January 21, 2010 11:51 AM | Report abuse

The Founders would likely have approved of national polls showing that 58% of Americans would prefer smaller government. That is kind of the basic idea on which this country was founded.

Obama has referred to limited government as, "...the failed ideas of the past," He has remarked that we shouldn't listen to, "... the people who got us into this mess in the first place." Those statement would not likely have met with the Founders approval.

Posted by: mgsorens | January 21, 2010 11:56 AM | Report abuse

The Founders did not see the need for a supermajority to move legislation through the Senate. This is clearly documented in the historical record. They meant the Senate to cool the desire to move legislation forward, not to freeze it completely. So they would have disagreed with current Senate rules, which require 60 votes to do anything not covered by reconciliation.

Posted by: jonawebb | January 21, 2010 12:05 PM | Report abuse

"There is no worse tyranny than to force a man to pay for what he does not want merely because you think it would be good for him." — Professor Bernardo de la Paz on the subject of taxes. – Robert Heinlein, “The Moon is a Harsh Mistress”.

Was true when the country was formed, was true when it was written, still true today.

Posted by: mhoust | January 21, 2010 12:23 PM | Report abuse

"The most generous country on the planet is also home to the most selfish people."

See, that's where you're entirely wrong. There was a study done a year or two ago that showed that those who identify as conservatives give, on average, a LOT more money to private charities than those who identify as liberals. It's not that we're selfish, it's that we don't think it's the government's role to tell us how to spend our money. We are a generous nation because we are a free nation - take one away, and there will go the other.

Posted by: cjmulrain | January 21, 2010 12:33 PM | Report abuse

Well. Good luck with the healthcare system you have now. That's all you are going to get. So please, don't get sick. If you do, your employer is free to fire you without cause. You will then be without health insurance and not afford health care. Good luck. Stay healthy.

Posted by: dlpetersdc | January 21, 2010 12:42 PM | Report abuse

Health care reform that is limited to the real needs of the population would be easy to pass without bribes and with broad public support.

Everything that the supporters of this bloated monstrosity used to try to sell it could have been written in a 25 page bill. It was the intrusiveness, costs and loss of liberty contained in the other 2500 pages that we rejected.

The bill created 200+ new agencies. The cost of this massive expansion of Federal employment was undefined and not included in the CBO scoring. Each state would have been required to create similar bureaucracies. The costs would have been staggering and would have provided no improvement in health care. In fact, reporting requirements on providers would have reduced the time available for patient care.

Posted by: Xdem | January 21, 2010 3:04 PM | Report abuse

"...difficult to pass health care..." BECUZ a plurality/majority DONT want it. Unions DONT want it; CONgress DOESNT want it for themselves. How about that for an explanation. BTW, I've read most of the bills, CBO docs and the Manager's Amendment. Another reason, the bill is TERRIBLE.

Posted by: JohnLeeHooker1 | January 21, 2010 3:23 PM | Report abuse

Mr. Lane gets it. Now if some of those blathering fools at the White House would pull out their Constitution and try to abide by it, we would all be better off.

Posted by: MIMI13 | January 21, 2010 4:31 PM | Report abuse

Xdem point is pretty much dead on here. Recall that Obama and his people went from open debate to reneging on the C-Span promise for a good reason.

The process involved in this kind of sweeping legislation is so onerous that all the extra addition tagged on is what did it in.

Once the people saw the comedy coming out about nebraska, reid, the tax on their insurance, union exemption, the reform became a nightmare of special interest spending spree that was never going to be budget neutral.

With Washington's track record on spending and staying on budget, only fools could believe the promise of budget neutrality.

The majority of americans who could balance their checkbook, and did not borrow beyond their means understand what just happened with the asset bubbles and credit squeeze was a result of too much spending by a sizable chunk of the populatiobn on assets without sufficient ability to repay.

And here we have washington executing a succession of large spending initiatives, creating horrendous deficits, now telling us that they will get it right this time with healthcare and be budget neutral. And to do it in such arrogant terms --- talking down towards the people who are had no trouble balancing their checkbooks! That is the ultimate in hubris.

This arogant disconnect with reality is what did them in in Massachusetts.

Posted by: mapledragon | January 21, 2010 7:23 PM | Report abuse

Oh those poor people who need it most foolishly fighting health care reform... The fact is the truly poor rarely vote. It is the well informed middle class voting block that pushed back in Massachusetts and elected Scott Brown. The single most prevalent characteristic of today's liberals is the belief that the people that don't agree with them are either uninformed or lacking in intelligence. That is obsurd and so long as liberals proceed with that mindset, they will continue to beat their heads against the wall. The people that disagree with the current health care takeover disagree BECAUSE THEY ARE INFORMED and simply do not agree with it. By the way, those poor people who allegedly need it most may not have insurance, but they still enjoy the best health care in the world via Medicaid and Medicare. Anyone, even illegals, get better health care in this country than anywhere in the world. All they have to do is walk into a hospital. It just isn't totally under the control of those all knowing liberals that think everyone else is too stupid to know better or to take care of themselves.

Posted by: saminsa | January 21, 2010 8:53 PM | Report abuse

Everybody likes to point out that: "The United States is the ONLY IDUSTRIALIZED NATION without National Health Care."
Yeah. What's your point? We're also the ONLY INDUSTRIALIZED NATION with a MILITARY. Yet I don't see these, same people, clamoring for those countries to BEEF UP their Armed Forces.
They also fail to mention, that these 'Other Countries' contribute SQUAT, to the MEDICAL WELL BEING of the WORLD. NO New Discoveries. No Medical Breakthroughs. No New Procedures. No New Medical Technologies. And No NEW LIFE SAVING DRUGS.
I know of NO-ONE leaving this country, because they can get BETTER TREATMENT someplace else. NO-ONE.
Am I getting through to you morons?

Posted by: GoomyGommy | January 22, 2010 7:11 AM | Report abuse

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