House Roll Call

Jeff Dobbs gleefully notes the margin for repeal comfortably exceeds the margin by which it passed:

March 21, 2010:
House passes health care bill on 219-212 vote

January 7, 2011:
House Votes to Repeal “Job-Killing” Health Care Law 236-181

In 2010, the Democrats passed ObamaCare by a 7 vote margin. In 2011, the Republicans passed the bill to repeal ObamaCare with a 55 vote margin.

Three out of four democrats voting for repeal were members of the 26 member Blue Dog Coalition: Dan Boren (2-OK), Mike McIntyre (7-NC), and Mike Ross (4-AR). Larry Kissel (8-NC), who also voted for repeal, is not a member.

The Politico story

Steeh’s decision referred to a number of intellectually questionable precedents expanding the Commerce Clause outrageously through the use of casuistical reasoning.

As Judge Steeh not inaccurately observes, a body of precedent law exists sustaining congressional edicts based on the constitutional power to regulate interstate commerce effectively reaching all sorts of persons and activities not in fact engaged in Interstate Commerce.

Post New Deal jurisprudential understanding of the Commerce Clause limitation amounted to the Constitution forbidding congressional interference only in cases of individual persons or activities that could not be in any way, shape or form theoretically causally connected (even negatively) to the national economy or to rational goals of liberal policy by clever and well-educated attorneys.

Such a standard is, of course, completely nugatory and impotent to stop anything at all, and Judge Steeh abashedly alludes to the relatively recent, and distinctly innovative for their era, cases of Morrison and Lopez to establish the contrary. I smiled ironically upon reading that.

The plaintiffs have not opted out of the health care services market because, as living, breathing beings, who do not oppose medical services on religious grounds, they cannot opt out of this market. As inseparable and integral members of the health care services market, plaintiffs have made a choice regarding the method of payment for the services they expect to receive. The government makes the apropos analogy of paying by credit card rather than by check. How participants in the health care services market pay for such services has a documented impact on interstate commerce. Obviously, this market reality forms the rational basis for Congressional action designed to reduce the number of uninsureds.

The Supreme Court has consistently rejected claims that individuals who choose not to engage in commerce thereby place themselves beyond the reach of the Commerce Clause. See, e.g., Raich, 545 U.S. at 30 (rejecting the argument that plaintiffs’ homegrown marijuana was “entirely separated from the market”); Wickard, 317 U.S. at 127, 128 (home-grown wheat “competes with wheat in commerce” and “may forestall resort to the market”); Heart of Atlanta Motel v. United States, 379 U.S. 241 (1964) (Commerce Clause allows Congress to regulate decisions not to engage in transactions with persons with whom plaintiff did not wish to deal). Similarly, plaintiffs in this case are participants in the health care services market. They are not outside the market. While plaintiffs describe the Commerce Clause power as reaching economic activity, the government’s characterization of the Commerce Clause reaching economic decisions is more accurate.

Judge Steeh’s decision is a competent and professionally produced example of carefully reasoned liberal statism, and very much represents the Keep-the-Constitution-in-Exile reasoning that will be used to defend Obamacare when the various state lawsuits eventually reach the Supreme Court.

The New Federalism and Rational Basis casuistry will meet again in the nation’s highest court before terribly long.

Ilya Somin, at Volokh, pessimistically believes the mandate is more likely to be upheld than not.

I think we have the better reasoning and a narrow conservative majority on the Court, backed by a national negative consensus on Obamacare. I’m not so sure we are going to lose.

Via John Zebraitis.

James Capretta, at National Review Online, takes a look at the first six months of “reform.”

He finds the foundations well underway for massive bureaucracy resulting in the politicization of patient care decisions, with the Obama Administration engaging in disinformation campaigns and power plays, and making threats against the livelihoods of businesses affected which protest.

During the long national debate over the future of American health care, President Obama frequently chastised his opponents for launching exaggerated attacks on his plan for “reform.” He took particular exception to the criticism that the changes he was pushing amounted to a government takeover of the whole health sector. He knew full well that this kind of criticism might derail the entire effort in Congress, because most Americans recoil at the thought of a distant and bureaucratic federal government running the health-care system for everyone. So Obama vigorously denied that his program would lead to any such thing. In his Aug. 8, 2009, radio address, he described the “takeover” accusation as “outlandish” and characterized his approach as a mainstream and moderate attempt simply to reform the nation’s private health-insurance system.

It’s now been six months since Congress passed Obamacare — not a long time given the sweeping nature of the legislation and the long phase-in schedule for its most significant provisions. Even so, it is already abundantly clear that Obamacare’s critics were dead right: The new health law has set in motion a government takeover of American health care, and a very hostile one at that. The Obama administration’s clumsy and overbearing behavior since its passage proves the point.

Read the whole thing.

Louis Case, at American Thinker, points out that the complicated Machiavellian shenanigans needed to get Obamacare through Congress inevitably include the potential legal seed of the destruction of the entire bill.

Virginia’s lawsuit argues that the federal government has no constitutional authority to require individuals to purchase health insurance policies.

Virginia is asserting that certain portions (that is, the personal mandate) of ObamaCare are unconstitutional. If Virginia prevails, it leaves the question of what happens to the rest of the ObamaCare statute. This is where the concept of severance comes in. Normally, all comprehensive laws contain a boilerplate severance clause: it says that if any portion of the law is found to be unconstitutional, that portion is severed from the rest of the law—that is, the rest of the law stands.

But ObamaCare contains no severance clause. Virginia is asserting that if it prevails on its substantive claims, the whole law is unconstitutional. (If Virginia does not prevail, any one of the twenty-plus legal challenges have the same severance argument available.)

If a severance clause is normal boilerplate, why does not ObamaCare contain one? This is where Scott Brown’s election enters. Recall that the House passed its version of ObamaCare. On Christmas Eve, after much horsetrading and bribing, the Senate passed its version. The Senate version was not drafted to be in its final form; it was drafted to get 60 votes. Normally, these bills would be reconciled in a conference committee, and the final version would have to be voted on again with 60 votes in the Senate. However, before it could be sent to conference and reconciled, Scott Brown won in Massachusetts—a reconciled bill could no longer get 60 votes! That is why the House had to vote up or down on the Senate bill, which was basically a draft without the normal boilerplate inserted.

As Virginia argued in its Memorandum (Pages 24 to 28), the presence of a severance clause raises a presumption that Congress did not intend the whole statute to depend on the constitutionality of any particular clause. But with no severance clause, they are not entitled to that presumption. A court cannot sever the offending clause on its own if the statute would not function as Congress intended.

Michael Barone observes HHS Secretary Kathleen Sebelius demonstrating exactly what Obamacare is really about: Power.

“There will be zero tolerance for this type of misinformation and unjustified rate increases.”

That sounds like a stern headmistress dressing down some sophomores who have been misbehaving. But it’s actually from a letter sent Thursday from Health and Human Services Secretary Kathleen Sebelius to Karen Ignagni, president of America’s Health Insurance Plans—the chief lobbyist for private health insurance companies.

Sebelius objects to claims by health insurers that they are raising premiums because of increased costs imposed by the Obamacare law passed by Congress last March.

She acknowledges that many of the law’s “key protections” take effect later this month and does not deny that these impose additional costs on insurers. But she says that “according to our analysis and those of some industry and academic experts, any potential premium impact … will be minimal.”

Well, that’s reassuring. Er, except that if that’s the conclusion of “some” industry and academic experts, it’s presumably not the conclusion of all industry and academic experts, or the secretary would have said so.

Sebelius also argues that “any premium increases will be moderated by out-of-pocket savings resulting from the law.” But she’s pretty vague about the numbers—“up to $1 billion in 2013.” Anyone who watches TV ads knows that “up to” can mean zero.

As Time magazine’s Karen Pickert points out, Sebelius ignores the fact that individual insurance plans cover different types of populations. So that government and “some” industry and academic experts think the new law will justify increases averaging 1 percent or 2 percent, they could justify much larger increases for certain plans.

Or as Ignagni, the recipient of the letter, says, “It’s a basic law of economics that additional benefits incur additional costs.”

But Sebelius has “zero tolerance” for that kind of thing. She promises to issue regulations to require “state or federal review of all potentially unreasonable rate increases” (which would presumably mean all rate increases).

And there’s a threat. “We will also keep track of insurers with a record of unjustified rate increases: those plans may be excluded from health insurance Exchanges in 2014.”

That’s a significant date, the first year in which state insurance exchanges are slated to get a monopoly on the issuance of individual health insurance policies. Sebelius is threatening to put health insurers out of business in a substantial portion of the market if they state that Obamacare is boosting their costs. ...

The threat to use government regulation to destroy or harm someone’s business because they disagree with government officials is thuggery. Like the Obama administration’s transfer of money from Chrysler bondholders to its political allies in the United Auto Workers, it is a form of gangster government.

Even with a Republican-controlled Senate, there will probably be enough RINOs from Maine and Massachusetts and other states to stop efforts to repeal the socialization of the American health care system, and even if we did have enough votes in the Senate, the Obamination has the veto.

But, leftwing Talking Points Memo is warning, a Republican House still has other tactics available. Most particularly, the power of the purse. The House can just defund Obamacare.

House GOP Conference Chair Mike Pence [said] “We’ll also use whatever means are available to delay implementation of Obamacare.”

Pence cited the “power of the purse”—Congress’ prerogative to appropriate funds to federal agencies—as a key tool at the Republicans’ disposal if they win back the House. That’s not just bluster.

“The most serious, yet realistic, possibility is precisely the one that you’re suggesting: what the Republicans can do through appropriations bills,” says Paul van de Water, a health care expert at the Center on Budget and Policy Priorities.

In short, implementing the health care law costs money. “Some money was provided in the health reform bill itself, but not by any means all the administrative funding that will be needed,” van de Water said. “If HHS and Treasury don’t get appropriations they need to run the law well, that could be a real problem. It’s not sexy but it’s serious.”

This can work one of few ways. House Republicans, in negotiations with the Senate, could demand appropriation levels beneath what’s necessary to effectively implement the law. If the two chambers reach an agreement—even an agreement that leaves the health care law cash strapped—Obama would be hard pressed to issue a veto. “It’s hard for the president to veto a bill because it doesn’t provide enough money.”

“In theory [they] could cut the funding 10 percent, 15 percent, 20 percent,” says Congressional expert Norm Ornstein of the American Enterprise Institute. “The problem is, you could do a lot of damage in a lot of different places.”

But things could shake out differently. An agreement might not be reached, for instance. Or, similarly, Republicans could simply “refuse to fund the entire Labor-HHS appropriations bill, or…pass an appropriation for Labor-HHS that does not include any funds for implementation of the health care plan,” as Ornstein put it.

“They could really bollocks things up if they say ‘none of the funds in this bill can be used to administrate the Affordable Care Act,” echoes van de Water.

That could lead to a veto and then a showdown between the White House and the Hill, mimicking the 1995 standoff between Bill Clinton and then-House Speaker Newt Gingrich. ...

There are other tricks the GOP could pull, too. “A second thing that they can do is hold a bunch of hearings and try to tie HHS and CMS into knots, by subpoenaing docs calling in of key figures to testify. In effect, deliberate sabotage to gum up the works,” Ornstein adds.

It’s all but impossible to get Democrats to discuss this threat openly—it’s election season, and they have to hew tightly to the line that a GOP takeover of the House is impossible. But it’s not.

Let’s make sure Republicans are prepared to follow through with exactly what TPM is warning about.

Not looking forward to dramatically increased health care insurance premiums and soon-to-be rationed services? Americans can console themselves that their sacrifices make it possible for Lady Bountiful Nancy Pelosi to encourage other Americans to quit those day jobs and follow their bliss.

0:36 video

“We see it as an entrepreneurial bill,” Pelosi said, “a bill that says to someone, if you want to be creative and be a musician or whatever, you can leave your work, focus on your talent, your skill, your passion, your aspirations because you will have health care.”

Hat tip to Tabitha Hale.

His Wikipedia bio describes him as a “marxist.” He is a Harvard professor and a technocrat with his own health care think tank. Naturally, Donald Berwick believes in central planning by experts like himself, and Barack Obama has nominated him for a post which will effectively give him the ability to impose a regime of treatments and protocols prescribed by a committee on every doctor and hospital in the United States. The new regime, of course, will have to be designed to supply services for free on a universal basis, so rationing and cost control will inevitably play a very key role in all the planning, but that’s just fine, Dr. Berwick tells us in the video below: “Excellent health care is by definition redistributional.”

Philip Klein, in the American Spectator, has details.

Obama’s choice to head the Centers for Medicare and Medicaid Services, Donald Berwick, [is] a Harvard professor with a self-professed love affair with Britain’s socialized health care system. In his writings and speeches, Berwick has defended government rationing and advocated centralized budget caps on health care spending.

“Cynics beware, I am romantic about the (British) National Health Service; I love it,” Berwick said in a July 2008 speech at England’s Wembley stadium. “All I need to do to rediscover the romance is to look at health care in my own country.”

While Berwick would not have the authority to impose a British health care system on the United States in one fell swoop, as head of CMS, he would be running both Medicare and Medicaid. Given that the two programs alone account for more than one out of every three dollars spent on health care in America (all government programs combined account for 47 percent), private players tend to follow CMS’s lead. Berwick himself has made this point.

“(G)overnment is an extraordinarily important player in the American health care scene, and it has inescapable duties with respect to improvement of care, or we’re not going to get improved care,” he said in a January 2005 interview with Health Affairs. “Government remains a major purchaser.… So as CMS goes and as Medicaid goes, so goes the system.”

There are two basic visions for how to contain the growth of health care spending. The free market approach would give individuals control over their health care dollars, with the idea that it would encourage more shopping that will drive down costs and increase quality as has happened in every other aspect of the consumer-based economy. But the other approach, employed by nations such as Britain, is to have the government ration care to meet a global budget.

President Obama rejected the market-based approach, and sought to drastically expand insurance coverage while reducing health care costs. But according to a report by CMS’s chief actuary, the new law will actually increase health care costs. That leaves rationing of care based on a bureaucratic notion of the common good as the remaining option for containing skyrocketing spending, and it’s an outcome that Berwick himself once predicted would be necessary to achieve universal coverage.

“(T)he Holy Grail of universal coverage in the United States may remain out of reach unless, through rational collective action overriding some individual self-interest, we can reduce per capita costs,” Berwick wrote in an article for Health Affairs he co-authored in 2008.

He went on to write that, “The hallmarks of proper financial management in a system… are government policies, purchasing contracts, or market mechanisms that lead to a cap on total spending, with strictly limited year-on-year growth targets.”

On a number of occasions, Berwick has praised Britain’s National Institute for Clinical Excellence (NICE), a body of experts that advises the government-run health care system on how to allocate medical spending based on cost-benefit analysis. Among other decisions, they have ruled against the use of cancer-treating drugs and put a dollar value on the final six months of human life.

“NICE is extremely effective and a conscientious, valuable, and—importantly—knowledge-building system,” Berwick said in an interview last June in Biotechnology Healthcare. “The fact that it’s a bogeyman in this country is a political fact, not a technical one.”

The national health care law that President Obama signed in March will greatly expand the role of CMS by adding an estimated 15 million beneficiaries to Medicaid. In addition, the law contains a number of initiatives, to be spearheaded by the Secretary of Health and Human Services in conjunction with the head of CMS, to provide incentive-based pay to doctors and hospitals based on performance. This builds on the comparative effectiveness research provision of last year’s economic stimulus package. While none of these measures will have the same sway as NICE does in Britain, taken together, they will move America in a NICE-like direction, especially with Berwick at the helm.

2:15 video
“Any health care funding plan that is just equitable civilized and humane must, must redistribute wealth from the richer among us to the poorer and the less fortunate. Excellent health care is by definition redistributional.” – Donald Berwick

Obama promised openness and “an honest process.” In reality, the bill was drafted by powerful democrat politicians behind closed doors, rammed into law via a series of shady political shortcuts around normal legislative rules, and the release of the results of an analysis by the government’s own economic experts deliberately delayed in order to conceal the truth from the public.

Washington Prowler:

The economic report released last week by Health and Human Services, which indicated that President Barack Obama’s health care “reform” law would actually increase the cost of health care and impose higher costs on consumers, had been submitted to the office of HHS Secretary Kathleen Sebelius more than a week before the Congressional votes on the bill, according to career HHS sources, who added that Sebelius’s staff refused to review the document before the vote was taken.

“The reason we were given was that they did not want to influence the vote,” says an HHS source. “Which is actually the point of having a review like this, you would think.”

Snotty progressives are laughing themselves silly over Nevada Senate candidate Sue Lowden’s reference to the old fashioned practice of impecunious patients compensating their doctor with gifts of goods or services.

In reality, back when I was a boy and even earlier, when you went to the doctor or the hospital, they just treated you. The modern custom of demanding that you fill out a form promising to pay and supply your insurance card before they look at you did not exist.

A small percentage of patients, of course, couldn’t, or wouldn’t, pay. In the old days, doctors just looked on treating such patients as their personal charitable contribution to the community and an inevitable part of the cost of practicing their profession.

The poor, of course, consisted of two kinds of people. There were the unfortunate but decent people, and there were the bums and deadbeats. Doctors could console themselves that they would only have to treat deadbeats once in a very long time, since shame would cause the deadbeat patient to go down the road to another physician the next time he was ill, and he’d naturally work his way through every available other doctor in the neighborhood before returning to the first.

Respectable people without money would find a way to compensate their doctor. One doctor I used to know as a boy received fresh baked bread every week from a widow on Social Security he’d taken care of. Men would turn up at the doctor’s house on Saturday, look over the premises, and find painting or repairs that needed to be done and start working without permission. Farmers without money would deliver fresh produce or meat. Yes, a doctor might well be given a number of chickens.

The left finds the idea that it is possible to try to discharge a debt informally and without cash changing hands funny. Personally, I’d say that all the sneering and crude guffawing over Ms. Lowden’s observation simply demonstrates all over again just how provincial, unsophisticated, and unfamiliar with normal life modern leftwing fashionistas really are.

One of my Yale classmates was snickering away this morning, sarcastically asking the doctors in the class how they’d like being paid by barter. I responded:

How about you? You’re a lawyer. Suppose some poor little old widow lady getting $600 a month on Social Security came to you and begged you to represent her. You know she can’t afford to pay you, and you know she needs the help. So when you solved her little problem, she sends you cookies at Xmas time every year. Does that work for you, or are you going to insist on a program forcing everybody in America to pay thousands of dollars a year for legal services insurance or go to jail, and a big federal bureaucracy rationing legal services and setting your fee schedule?

Hat tip to John Hinderaker via the News Junkie.

Michelle Malkin, in the New York Post, describes how the thuggish efforts to punish corporations for describing the negative impact of the health care bill backfired on Henry Waxman.

The House Democrats’ Torquemada got cold feet. Self-styled “chief inquisitor” Henry Waxman announced this week that he’s canceling a planned show trial of corporate executives who called public attention to the financial hit they’re taking as a result of President Obama’s health-care mandate. Business owners can breathe a small sigh of relief. But the witch hunt isn’t over.

You’ll recall that Waxman fired off nasty-grams to the heads of Deere, Caterpillar, Verizon and AT&T last month, demanding their presence at a congressional auto de fé. Their sin? Publicly reporting the costs and consequences of federal health-care taxes on their firms’ bottom lines.

A vindictive Waxman sought internal documents and e-mails from the CEOs about the profit charges. Commerce Secretary Gary Locke took to the White House blog and TV airwaves to condemn the “premature” and “irresponsible” disclosures. ...

An April 14 memorandum from the Committee on Energy and Commerce Majority Staff informed the Democratic hounds that the “companies acted properly and in accordance with accounting standards in submitting filings to the Securities and Exchange Commission in March and April.”

Indeed, after haggling about the overall impact of the health-care mandate on firms’ annual company cash flows, the staff memo acknowledged that notifying shareholders of these big one-time company write-downs was required by law.

No apology from Locke or Waxman has been forthcoming. Instead, the ruling majority seems bent on pressuring private companies to peddle the “beneficial” impacts of the law. The committee staff extracted statements from the targeted companies that “if” implemented “right” and “correct[ly],” ObamaCare “could” achieve “long term savings for the country” and their businesses.

Interestingly, my liberal friends felt sure that the costs would not be significant.

Jonah Goldberg offers the argument, which I think we are going to see repeated and elaborated, that the cost of socializing the United States is liable to go far beyond high domestic taxes and less US economic growth, and the full cost may seriously impact Europe, too.

[L]iberals insist conservatives are wrong to think that Europeanizing America will necessarily come at any significant cost. New York Times columnist and Princeton economist Paul Krugman says that in exchange for only a tiny bit less growth, Europeans buy a whole lot of security and comfort. ...

I think the debate misses something. We can’t become Europe unless someone else is willing to become America.

Look at it this way. My 7 year-old daughter has a great lifestyle. She has all of her clothes and food bought for her. She goes on great vacations. She has plenty of leisure time. A day doesn’t go by where I don’t look at her and feel envious at how good she’s got it compared to me. But here’s the problem: If I decide to live like her, who’s going to take my place?

Europe is a free-rider. It can only afford to be Europe because we can afford to be America.

The most obvious and most cited illustration of this fact is national defense. Europe’s defense budgets have been miniscule because Europeans can count on Uncle Sam to protect them. Britain, which has the most credible military in NATO after ours, has funded its butter account with its gun account. As Mark Steyn recently noted in National Review, from 1951 to 1997 the share of British government expenditure on defense fell from 24 percent to 7 percent, while the share on health and welfare increased from 22 percent to 53 percent. And that was before New Labor started rolling back Thatcherism. If America Europeanizes, who’s going to protect Europe? Who’s going to keep the sea lanes open? Who’s going to contain Iran? China? OK, maybe. But then who’s going to contain China?

But that’s not the only way in which Europeans are free-riders. America invents a lot of stuff. When was the last time you used a Portuguese electronic device? How often does Europe come out with a breakthrough drug? Not often, and when they do, it’s usually because companies like Novartis and GlaxoSmithKline increasingly conduct their research here. Indeed, the top five U.S. hospitals conduct more clinical trials than all the hospitals in any other single country combined. We nearly monopolize the Nobel Prize in medicine, and we create stuff at a rate Europe hasn’t seen since da Vinci was in his workshop.

If America truly Europeanized, where would the innovations come from?

Individuals who don’t purchase health insurance may lose their tax refunds according to IRS Commissioner Doug Shulman. After acknowledging the recently passed health-care bill limits the agency’s options for enforcing the individual mandate, Shulman told reporters that the most likely way to penalize individuals that don’t comply is by reducing or confiscating their tax refunds.

The American public’s lack of enthusiasm for the health care bill is clearly getting to the Obamination. At a question session following a speech by the President in Charlotte, when a woman referred to being overtaxed, the Chosen One lost it and responded with a tortuous rambling diatribe.

WaPo:

Even by President Obama’s loquacious standards, an answer he gave here on health care Friday was a doozy.

Toward the end of a question-and-answer session with workers at an advanced battery technology manufacturer, a woman named Doris stood to ask the president whether it was a “wise decision to add more taxes to us with the health care” package.

“We are over-taxed as it is,” Doris said bluntly.

Obama started out feisty. “Well, let’s talk about that, because this is an area where there’s been just a whole lot of misinformation, and I’m going to have to work hard over the next several months to clean up a lot of the misapprehensions that people have,” the president said.

He then spent the next 17 minutes and 12 seconds lulling the crowd into a daze. His discursive answer – more than 2,500 words long—wandered from topic to topic, including commentary on the deficit, pay-as-you-go rules passed by Congress, Congressional Budget Office reports on Medicare waste, COBRA coverage, the Recovery Act and Federal Medical Assistance Percentages (he referred to this last item by its inside-the-Beltway name, “F-Map”). He talked about the notion of eliminating foreign aid (not worth it, he said). He invoked Warren Buffett, earmarks and the payroll tax that funds Medicare (referring to it, in fluent Washington lingo, as “FICA”).

Byron York points to statements by supporters identifying the ideological motivation behind supposed “reform.”

It hasn’t attracted much notice, but recently some prominent advocates of Obamacare have spoken more frankly than ever before about why they supported a national health care makeover. It wasn’t just about making insurance more affordable. It wasn’t just about bending the cost curve. It wasn’t just about cutting the federal deficit. It was about redistributing wealth.

Health reform is “an income shift,” Democratic Sen. Max Baucus said on March 25. “It is a shift, a leveling, to help lower income, middle income Americans.”

In his halting, jumbled style, Baucus explained that in recent years “the maldistribution of income in America has gone up way too much, the wealthy are getting way, way too wealthy, and the middle income class is left behind.” The new health care legislation, Baucus promised, “will have the effect of addressing that maldistribution of income in America.”

At about the same time, Howard Dean, the former Democratic National Committee chairman and presidential candidate, said the health bill was needed to correct economic inequities. “The question is, in a democracy, what is the right balance between those at the top … and those at the bottom?” Dean said during an appearance on CNBC. “When it gets out of whack, as it did in the 1920s, and it has now, you need to do some redistribution. This is a form of redistribution.”

Summing things up in the New York Times, the liberal economics columnist David Leonhardt called Obamacare “the federal government’s biggest attack on economic inequality since inequality began rising more than three decades ago.”

Now they tell us. For many opponents of the new legislation, the statements confirmed a nagging suspicion that for Barack Obama and Democrats in Congress, the health fight was about more than just insurance—that redistribution played a significant, if largely unspoken, part in the drive for national health care.

Read more at the Washington Examiner.

Shelby Steele reflects on the irony inherent in Barack Obama’s need to pursue his personal star by ramming socialism down a center right nation’s throat.

Of the two great societal goals—freedom and “the good”—freedom requires a conservatism, a discipline of principles over the good, limited government, and so on. No way to grandiosity here. But today’s liberalism is focused on “the good” more than on freedom. And ideas of “the good” are often a license to transgress democratic principles in order to reach social justice or to achieve more equality or to lessen suffering. The great political advantage of modern liberalism is its offer of license on the one hand and moral innocence—if not superiority—on the other. Liberalism lets you force people to buy health insurance and feel morally superior as you do it. Power and innocence at the same time.

This is an old formula for power, last used effectively on the presidential level by Lyndon Johnson. But Johnson’s Great Society was grasping for moral authority after the civil rights movement. I doubt any white president could use it effectively today, and even ObamaCare passed by only a three vote margin in the House and with no Republican support at all. Worse, in the end, it passed not to bring the nation better health care but to pull a flailing Democratic presidency back from the brink.

There has always been a narcissistic charge around Mr. Obama, the sense that in embracing him one was embracing something special in oneself—and possibly even a larger idea of human perfectibility. Every politician wants this capacity to attract identification. But it is also a trap. What happens when people are embarrassed for having seen themselves in you?

The old fashioned, big government liberalism that Mr. Obama uses to make himself history-making also alienates him in the center-right America of today. It makes him the most divisive president in memory—a president who elicits narcissistic identification on the one hand and an enraged tea party movement on the other. His health-care victory has renewed his narcissistic charge for the moment, but if he continues to be a 1965 liberal it will become more and more impossible for Americans to see themselves in him.

Mr. Obama’s success has always been ephemeral because it was based on an illusion: that if we Americans could transcend race enough to elect a black president, we could transcend all manner of human banalities and be on our way to human perfectibility. A black president would put us in a higher human territory. And yet the poor man we elected to play out this fantasy is now torturing us with his need to reflect our grandiosity back to us.

A Democratic senator I can’t name, who reluctantly voted for the health-care bill out of loyalty to his party and his admiration for Barack Obama, privately complained to me that the measure was political folly, in part because of the way it goes into effect: some taxes first, most benefits later, and rate hikes by insurance companies in between.

Besides that, this Democrat said, people who already have coverage will feel threatened and resentful about helping to cover the uninsured—an emotion they will sanitize for the polltakers into a concern about federal spending and debt.

On the day the president signed into law the “fix-it” addendum to the massive health-care measure, two new polls show just how fearful and skeptical Americans are about the entire enterprise. If the numbers stay where they are—and it’s not clear why they will change much between now and November—then the Democrats really are in danger of colossal losses at the polls.

Unlike President Obama’s recent health care handiwork, the 1988 law was a genuinely bipartisan achievement passed by lopsided margins. It was signed into law by a Republican president, Ronald Reagan. It offered all kinds of new benefits, including expanded coverage of hospital stays, at-home care, and prescription drugs (the act was in some respects of a forerunner of Medicare Part D).

The Medicare Catastrophic Coverage Act was nevertheless repealed a year later. No change in partisan control of Washington was necessary—the repeal was passed by a Democratic Congress and signed into law by another Republican president, George H.W. Bush. The repeal turned out to be most popular with the elderly voters who had demanded the new benefits in the first place.

Why? In addition to creating new benefits, the reform also imposed staggering new costs. Those costs fell most heavily on the senior citizens who were supposed to be the program’s biggest constituency. But, congressional Democrats were astonished to learn, many of these seniors were happy with their existing coverage and resented having to pay a new tax to fund this expansion of government—costs which kicked in before many of the benefits.

Sound familiar? The similarities don’t end there. Members of Congress also had to hear from angry mobs opposed to the legislation, otherwise known as their constituents. The most memorable such incident occurred on Aug. 17, 1989, when House Ways and Means Chairman Dan Rostenkowski (D-Ill.) held a meeting in his district to sell seniors on the benefits of the catastrophic coverage act.

Instead of being won over by their powerful congressman, the angry seniors waved protest signs and ran him out of the room. As Rostenkowski fled, they shouted “coward,” “recall,” and “impeach.” One elderly woman wearing heart-shaped glasses even threw herself on the hood of Rostenkowski’s car to keep him from leaving.

Rostenkowski got out of the car and tried to escape on foot. The crowd chased him for about a block before his driver came to whisk him away. Imagine what would be said if the Tea Party movement did something like that. Instead the protest was organized by one Jan Schakowsky, then director of the Illinois State Council of Senior Citizens, now a Democratic congresswoman and chief deputy whip for House Speaker Nancy Pelosi.

The protest made the national news and graced the front pages of newspapers. It also had its desired affect—the catastrophic coverage act was repealed within three months.

The 1988 legislative debacle did not resemble this year’s bill with respect to partisanship or initial public support. Democrats had no problem getting Republican votes, and the public was behind it.

However, 1988 does resemble 2010 with respect to the same kind of irresponsible drafting of a dreadfully large and complex bill that was voted into law without serious consideration of its costs and effects. It backfired then, and a lot of people would predict that the new health care bill will prove in practice similarly distressing to many of its intended beneficiaries.

Remember how the commentators on the left were predicting that the voters would change their minds and start liking Obamacare, once it was passed?

Rassmussen’s latest poll demonstrates otherwise.

One week after the House of Representatives passed the health care plan proposed by President Obama and congressional Democrats, 54% of the nation’s likely voters still favor repealing the new law. The latest Rasmussen Reports national telephone survey shows that 42% oppose repeal.

Those figures are virtually unchanged from last week. They include 44% who Strongly Favor repeal and 34% who Strongly Oppose it.

Repeal is favored by 84% of Republicans and 59% of unaffiliated voters. Among white Democrats, 25% favor repeal, but only one percent (1%) of black Democrats share that view.

Only 17% of all voters believe the plan will achieve one of its primary goals and reduce the cost of health care. Most (55%) believe it will have the opposite affect and increase the cost of care.

Forty-nine percent (49%) believe the new law will reduce the quality of care. Sixty percent (60%) believe it will increase the federal budget deficit. Those numbers are consistent with expectations before the bill was passed.

We are now $8 trillion in debt. The Congressional Budget Office projects that $12 trillion will be added over the next decade. Obamacare, when stripped of its budgetary gimmicks—the unfunded $200 billion-plus “doctor fix,” the double counting of Medicare cuts, the 10-6 sleight-of-hand (counting 10 years of revenue and only six years of outflows)—is at minimum a $2 trillion new entitlement.

It will vastly increase the debt. But even if it were revenue-neutral, Obamacare preempts and appropriates for itself the best and easiest means of reducing the existing deficit. Obamacare’s $500 billion of cuts in Medicare and $600 billion in tax hikes are no longer available for deficit reduction. They are siphoned off for the new entitlement of insuring the uninsured.

This is fiscally disastrous because, as President Obama himself explained last year in unveiling his grand transformational policies, our unsustainable fiscal path requires control of entitlement spending, the most ruinous of which is out-of-control health-care costs.

Obamacare was sold on the premise that, as Nancy Pelosi put it, “health-care reform is entitlement reform. Our budget cannot take this upward spiral of cost.” But the bill enacted on Tuesday accelerates the spiral: It radically expands Medicaid (adding 15 million recipients/dependents) and shamelessly raids Medicare by spending on a new entitlement the $500 billion in cuts and the yield from the Medicare tax hikes.

Obama knows that the debt bomb is looming, that Moody’s is warning that the Treasury’s AAA rating is in jeopardy, that we are headed for a run on the dollar and/or hyperinflation if nothing is done.

Hence his deficit-reduction commission. It will report (surprise!) after the November elections.

What will it recommend? What can it recommend? Sure, Social Security can be trimmed by raising the retirement age, introducing means testing and changing the indexing formula from wage growth to price inflation.

But this won’t be nearly enough. As Obama has repeatedly insisted, the real money is in health-care costs—which are locked in place by the new Obamacare mandates.

That’s where the value-added tax comes in. For the politician, it has the virtue of expediency: People are used to sales taxes, and this one produces a river of revenue. Every 1 percent of VAT would yield up to $1 trillion a decade (depending on what you exclude—if you exempt food, for example, the yield would be more like $900 billion).

It’s the ultimate cash cow. Obama will need it. By introducing universal health care, he has pulled off the largest expansion of the welfare state in four decades. And the most expensive. Which is why all of the European Union has the VAT. Huge VATs. Germany: 19 percent. France and Italy: 20 percent. Most of Scandinavia: 25 percent.

American liberals have long complained that ours is the only advanced industrial country without universal health care. Well, now we shall have it. And as we approach European levels of entitlements, we will need European levels of taxation.

‘And so when you walk into that ballot box, remember that it was my Democratic opponent who favored providing Viagra to pedophiles.”

That isn’t a campaign line any American has heard yet, but give it a few hours. The Senate this week took up its “reconciliation” bill, with its final changes to the law the president signed Tuesday. It wasn’t so much reconciliation as reckoning.

Democrats only got their ObamaCare victory by breaking every rule, and that was always going to come at a price. To lever the health bill through the House, Democrats used the arcane process of reconciliation. It got them a win, but it also meant Senate Democrats this week had to endure the political equivalent of water-boarding.

Here’s why: reconciliation allowed Republicans to bring up unlimited amendments. Because Majority Leader Harry Reid (D., Nev.) could not allow the reconciliation bill to be changed in any way—which would send it back to the House—his party was obliged to vote down every one of those amendments. And every one had been designed to make even hardened pols whimper.

Tom Coburn (R., Okla.) offered language to bar the government from subsidizing erectile dysfunction drugs for convicted pedophiles and rapists. Democrats voted . . . No! Orrin Hatch (R., Utah) proposed exempting wounded soldiers from the new tax on medical devices. Democrats: No way! Pat Roberts (R., Kan.) wanted to exempt critical access rural hospitals from funding cuts. Senate Democrats: Forget it! This was Republicans’ opportunity to lay out every ugly provision and consequence of ObamaCare, and Democrats—because of the process they’d chosen—had to defend it all.

And so it went, into the wee Thursday hours. All Democrats in favor of taxing pacemakers? Aye! All Democrats in favor of keeping those seedy vote buyoffs? Aye! All Democrats in favor of raising taxes on middle-income families? Aye! All Democrats in favor of exempting themselves from elements of ObamaCare? Aye! All Democrats in favor of roasting small children in Aga ovens? (Okay, I made that one up, but you get the point.) Aye!

Aye-yi-yi.

These votes are “ridiculous” huffed Connecticut Democrat Chris Dodd. Republicans are not being “serious” grumped Mr. Reid. Of course, “ridiculous” and “not serious” better apply to ObamaCare, which was in fact the substantive point of amendments like Mr. Coburn’s. A 2005 survey found that some 800 convicted sex offenders had—whoops—received Medicaid-funded impotence drugs. This is what happens when a big, inefficient government runs health care, and as Mr. Coburn noted, it is about to do it on a bigger, more inefficient scale than ever, thanks to ObamaCare.

Since the health bureaucracy can’t be trusted, the only way to guarantee a subsidy’s end is to ban them with legislation. And since Democrats didn’t allow Republicans to help craft the bill, this was Mr. Coburn’s best shot. And since the majority had by then boxed itself in, it is now on record as being OK with little blue pills for pedophiles. Unfortunate, really, since most members obviously are not. But hey, three cheers for reconciliation!

No more hiding, either, by Democrats who voted for ObamaCare even as they claimed to have reservations. Republicans flushed them out, making each individual Democrat stand up to defend each individual piece. The record now shows that Arkansas’s Blanche Lincoln is on board with higher premiums, that Colorado’s Michael Bennet is good to go with gutting Medicare Advantage, that Nevada’s Harry Reid is just fine with rationing, that New York’s Kirsten Gillibrand is cool with taxes on investment income, that California’s Barbara Boxer is right-o with employer mandates, and that Pennsylvania’s Arlen Specter is willing to strip his home state of the right to opt out of the health law.

Hat tip to Bird Dog.

Senate Republicans succeeded early Thursday morning in finding two flaws in the House-passed health care reconciliation package. Neither is of any substance, but the Senate parliamentarian informed Democratic leaders that both are in violation of the Byrd Rule.

One is related to Pell Grants and the other makes small technical corrections. Why they’re in violation of the Byrd Rule doesn’t matter; the upshot is that Republicans will succeed in at least slightly altering the legislation, which means that the House is once again required to vote on it. With no substantial changes, House Speaker Nancy Pelosi (D-Calif.) should have little problem assembling the same coalition of 220 Democrats who passed the measure Sunday night. That’s already four more than the minimum 216 required for passage.

But the ruling might give Democrats another option—the public one.

Democratic leadership no longer has to worry that additional amendments would send it back to the House, since it must return to the lower chamber regardless. The Senate is now free to put to the test that much-debated question of whether 50 votes exist for a public option. Democrats could also elect to expand Medicare or Medicaid, now that they only need 50 votes in the Senate and the approval of the House.

The question then becomes whether House Speaker Nancy Pelosi (D-Calif.) could pass the reconciliation changes with a public option. She has long maintained that the House has the votes to do so. Indeed, it did so in late 2009. Since then, however, two members who supported the public option are no longer in the House. But with fewer members, the House also needs two fewer votes than the 218 required for a majority in November, alleviating some of that pressure.

Would they have the votes?

Washington Post:

Cuban revolutionary leader Fidel Castro on Thursday declared passage of American health care reform “a miracle” and a major victory for Obama’s presidency, but couldn’t help chide the United States for taking so long to enact what communist Cuba achieved decades ago.

“We consider health reform to have been an important battle and a success of his (Obama’s) government,” Castro wrote in an essay published in state media, adding that it would strengthen the president’s hand against lobbyists and “mercenaries.”

But the Cuban leader also used the lengthy piece to criticize the American president for his lack of leadership on climate change and immigration reform, and for his decision to send more troops to Afghanistan, among many other things.

And he said it was remarkable that the most powerful country on earth took more than two centuries from its founding to approve something as basic as health benefits for all.

“It is really incredible that 234 years after the Declaration of Independence … the government of that country has approved medical attention for the majority of its citizens, something that Cuba was able to do half a century ago,” Castro wrote.

I agree with Castro. It is incredible that the United States managed to preserve freedom so long.

As democrats complain loudly that Congressmen who voted for Obamacare are being threatened and harassed by outraged voters, John Hinderaker asks aloud, “What Was That Line About the Tree of Liberty and the Blood of Tyrants?”

The peril of the socialist legislators is doubtless being exaggerated in order to score political points, but Power Line makes a telling point in response. If a measure abridging liberty and expanding government authority is so unpopular that legislators are receiving threats from ordinary Americans, doesn’t that suggest that those legislators are not really functioning very effectively as representatives of the people and that something has gone seriously awry in the relationship between the governing and the governed?

During the course of this decade we will witness a global battle over the fate of the nascent Bully State. The Bully State will be this decade’s ‘bad cop’ to the Nanny State’s ‘good cop’ of past decades.

The past generation of welfare statism saw the unduly protective Nanny State bleed into every sinew of our daily lives. Sociologist David Marsland explains that, ‘Once you have a big welfare state in place, the excuse for state nannying is infinite in scale’, he says. ‘This … continues the process of reducing self-reliance and handing responsibility for ourselves to external bodies.’

Yet, just when you thought things could not get worse, they did. Two years ago, Oxford University’s Nuffield Council of Bioethics published a seminal report that provided the international public health establishment with the explicit rationale for a dramatic change in the relationship between the citizen and the State.

Did anyone think national health care was really going to be free?

Hat tip to the News Junkie.

One such surprise is found on page 158 of the legislation, which appears to create a carveout for senior staff members in the leadership offices and on congressional committees, essentially exempting those senior Democrat staffers who wrote the bill from being forced to purchase health care plans in the same way as other Americans.

Christopher Demuth explains that, in endeavoring to establish European-style national health care in America, the left is acting upon a core belief: its faith in the calculative power of human reason to perfect the world.

[M]any liberals today are also progressives. They believe that the natural course of history is the emergence of secular rationality as the true way to think about problems and of state power as the effective way to organize society along rational lines. If that is your worldview, then such things as revealed religion, cultural tradition, and the marketplace (whose outcomes are spontaneous, not rationalized) are vestiges of our primitive past, sure to be displaced by the spreading application of human reason. When liberal politicians describe themselves as “progressives,” that is not just because “liberal” has acquired unpopular connotations but because progressive is the more accurate word for their core beliefs. President Obama, House Speaker Nancy Pelosi, and Senator Majority Leader Harry Reid are progressives in this sense; many recent Democratic presidential candidates were as well—John Kerry, Al Gore, and Michael Dukakis.

The grip of progressivism is probably the best explanation for the Democratic Party’s astonishing campaign to nationalize the U.S. healthcare sector by all means necessary. To attempt to enact a radical and unpopular program in a bill that includes many corrupt provisions, on a party-line vote and through a procedural trick (if the “Slaughter solution” is employed) that seems clearly unconstitutional, appears quite mad and self-defeating to the outsider. But it is not mad at all to those who think it natural and obvious and historically inevitable that the government must administer medical care. In this view, the political actor is simply holding history’s coat while it does its work. Political untidiness, even the loss of an election, are transitory considerations. The progressive mindset also explains, as more than populist demagoguery, the contempt that the proponents of ObamaCare exhibit for doctors and pharmaceutical and medical-insurance companies—for they are the practitioners of a benighted form of healthcare that is about to be swept away by a new and higher form.

The best artistic expression of leftist faith is a new world ruled by secular experts is Mozart’s Masonic opera The Magic Flute (K. 620, 1791).

Liberalism/leftism is a secular religion, and the liberal impulse toward federalizing charity stems from a number of consistently present liberal impulses. Liberalism is a cult with the state at its center in which the credentialed intelligentsia is its priesthood. Anything expanding the power and responsibility of the state inevitably also aggrandizes and affirms the importance of its priesthood, so all state enlargement is good. Socializing, regulating, and nationalizing everything is seen as the fulfillment of the promise that the entire universe can be subdued and rationalized by the calculative powers of human reason wielded by the super-enlightened, educated class of experts. Mankind’s destiny and the fulfillment of the telos of History consists in the continual reduction of the natural, free, and disordered condition of mankind, the market and the world into an ordered, regulated, and managed sphere administered by the intelligentsia under the aegis of the state.

“Es lebe Sarastro! Sarastro soll leben! Er ist es, dem wir uns mit Freuden ergeben. Stets mög’ er des Lebens als Weiser sich freun, Er ist unser Abgott, dem alle sich weihn.”

9:28 video

The poor are invaluable to the priesthood of Leviathan, since it is their neediness which allows the most spoiled and privileged element of society to complain bitterly on their behalf and to demand indignantly that ordinary people surrender to them ever-increasing portions of their liberty and wealth. The poor must be assisted and cared for, you see.

The theoretical elimination of poverty by coercive wealth transfer and social engineering is a key goal of the left’s statist agenda. The replacement of the untidy state of Nature with a manicured and properly managed society is expected to demonstrate irrefutably the superiority of human reason over the former. The leveling of social and biological differences, the abolition of tragedy, and the replacement of charity with entitlement will also firmly establish the leftwing ideal of Égalité, it is supposed, as reality.

The implementation of this costly and coercive agenda is, of course, wholly agreeable to the left because each step in the process only enlarges the power, privilege, and importance of mankind’s enlightened new masters, and the entire process was always intended to be funded at the expense of the ordinary citizen, the general population.