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Health Care: Indefensible From Any Angle

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The recent passage within the House and Senate of markedly different versions of comprehensive health care legislation should not be viewed (despite what nearly all Democrats and the President are quick to claim) as historic, landmark, or positive in any productive way. Theses bills are not defensible by reasonable people.

These proposals are the most expensive and affect more citizens than ANYTHING ever before considered in the US Congress. Think about that. Therefore you might think that such bills would reflect an appropriate level of thoroughness, professionalism and deliberation in their consideration and passage. You would be wrong. Based on three measures: historic comparison to actual "Landmark Votes", quality of the legislation, and manner in which the bills were passed it is obvious that these fail to measure up to anything that can be considered responsible legislation. They should therefore not be sent to the President or imposed upon the people in anything close to their current forms.

Let's review the health care legislation in the context of each of these measures and see that these bills are not anything to be proud of:

Historic comparison of Health Care to Real "Landmark Votes"

Recall there was a requirement for 9 of 13 states to vote in order to ratify the Constitution. This reflected the profound impact and scope of that fundamental change in governance and the need to gain the acceptance of the public. A simple majority would not do. Viewed in these terms the ability to pass legislation of profound cost and which impacts the entire populace with just the narrowest of mathematical margins loses it's steam. While it is necessary to have a majority in order to pass legislation, the presence of a mere majority is not sufficient to pass groundbreaking legislation that will, both immediately and over the long term, sit well with the people, be effective, and not be prone to massive and/or convulsive modification or repeal. The implementation of such legislation requires stronger and more consistent agreement both among the legislators and the people.

Thus as legislation grows in scope, impact, and importance, the requirement for larger majorities in favor of it's passage grows as well. We see this reflected in the Constitution and Congressional rules with simple majorities for most things, some 3/5 majorities for stopping Senate debate etc., 2/3 majorities for accepting treaties, and majorities for state ratification of Constitutional amendments for example. This parallel between size and scope of legislation and the need for a bigger majority to accompany it's passage is at the heart of good government. Historically this principle of gaining bipartisan support has been at work in the larger legislative actions undertaken by Congress. We see this is Charts 1 and 2.

As we see, comparing the passage of Social Security, Medicare, Civil Rights, and the Use of force in Iraq all reveal substantially more support than was just seen in the passage of health care legislation. The only legislative action that is similar to health care is the 2002 Prescription drug plan (although it enjoyed substantially higher minority support than does health care).

The Social Security, Medicare, Civil Rights, and Iraq force votes all exceed the 2/3 majority in both Houses of Congress. This is a significant milestone toward promoting good government and one where to date the health care legislative actions falls woefully short.

The poor attitudes of the public toward the Congress, It's leadership, and the President demonstrated in Chart 1 are warning signs that the willingness of the people to accept mere mathematically permissible margins on this historically largest of legislative actions is not great. Good government and respect for past decisions demands more bipartisanship.

An example of how support impacts acceptance is that Ted Kennedy, 'Mr. Health Care for the Democrats' who did not support the 2003 Prescription Drug plan was prompted to basically state that the plan should essentially be repealed and replaced with a real prescription drug policy. This statement grew no doubt because the drug package lacked fundamental and widespread support.

"The test of every great civilization is how it cares for its elderly," said Sen. Ted Kennedy, D-Mass., one of the staunchest foes of the measure. "I am absolutely convinced that at the end of the day we will preserve the Medicare system, which is threatened, threatened seriously by this proposal, and we will get the day when we have a real prescription drug program, which our seniors deserve and which this nation owes to those individuals.",2933,104004,00.html

Quality of the legislation

These bills (including Manager's amendments) are currently in the range of 2000 to 2500 pages of legislation depending on which version you see. Such a massive and intricately worded set of new rules, taxes, and policies deserve a serious, not cursory, review.

The primary mechanisms (public option or regulated "exchange") are totally unproven concepts that have had no demonstration of success in the real world. No example of actual and fair competition between a public (government) entity and private interests has been identified by the supporters of the public option. No discussion of possible unintended consequences or other difficult to foresee effects has occurred. No measurement parameters, milestones, or criteria for success has been identified to insure that these huge programs are accomplishing their goals.

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Ken Scott is a self-employed engineer (nuclear and computer) and patriot living in North Carolina. I also publish and comment at
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