Tuesday, February 01, 2011


Ezra Klein and Kevin Drum have apparently been hitting the salvia really hard lately. Here's Ezra on what might happen if the Supreme Court accepts Judge Roger Vinson's argument that the unconstitutionality of the individual mandate invalidates the entire health care law:

There's a chance conservatives will come to seriously regret this stratagem. I think it's vanishingly unlikely that the Supreme Court will side with Judge Vinson and strike down the whole of the law. But in the event that it did somehow undermine the whole of the law and restore the status quo ex ante, Democrats would start organizing around a solution based off of Medicare, Medicaid, and the budget reconciliation process -- as that would sidestep both legal attacks and the supermajority requirement.

The resulting policy isn't too hard to imagine. Think something like opening Medicare to all Americans over age 45, raising Medicaid up to 300 percent of the poverty line, opening S-CHIP to all children, and paying for the necessary subsidies and spending with a surtax on the wealthy (which is how the House originally wanted to fund health-care reform). That won't get us quite to universal health care, but it'll get us pretty close. And it'll be a big step towards squeezing out private insurers, particularly if Medicaid and Medicare are given more power to control their costs.

Is this before or after we cure all terminal diseases, wipe out poverty, and spin all the straw in America into gold?

Kevin's fever dream seems a bit more rational, but it's only because he thinks we have to go on a long journey before we (inevitably) arrive at the Promised Land:

In the long run, I'm sure Ezra is right. But we all remember what Keynes said about the long run, right? And the short run, unfortunately, doesn't look very promising. Democrats aren't likely to control the House anytime soon, and even if they do, they won't have effective liberal control. Ditto for the Senate, where Democrats are defending a lot of swing seats in 2012. And in 2016, it's pretty likely that a Republican will win the presidency. In other words, if PPACA is struck down, the soonest that some kind of single-payerish semi-universal healthcare scheme could pass is probably around 2024.

I'm not even sure I believe a Republican is going to win the presidency in 2016 (Kevin is certain Obama will be reelected in 2012). But it doesn't matter. In fact, it might not even be a good thing for progressive causes if Democrats continue to win presidential elections.

On paper, what we've had in the past few decades is an orderly alternation of Democratic, Republican, and divided governments. What we've had in fact is a decades-long Republicanization -- a Republicanization that actually seems to pick up steam in those rare moments when Democrats control the government, because Democrats tend to take over in times of crisis (the stagflation/OPEC '70s, the post-S&L-crisis '90s, the current era), and right-wing rhetoric soon blames Democrats for problems they inherited and couldn't immediately solve, and for trying to solve other problems in tough times. This pushes Democrats to the right -- toward deregulation or deficit hawkery or mollycoddling of business. And then, of course, when Republicans gain any power, they dominate D.C. -- and they, of course, have been heading further and further rightward without pause for decades.

And non-right-wing ordinary citizens never get up off the couch and demand that attention be paid to their needs. No one fought in the streets for even this weak-tea health care law -- there certainly weren't loud demands for the kinds of reforms Ezra and Kevin think are possible.

What development is going to make future Republicans less likely to fight a genuine near-socialization of health care? Or make Democrats willing to fight for it? I think folks like Ezra and Kevin think this will happen because they wonkily squint at their pie charts and their think-tank reports and believe it just has to. Well, there just has to be a national response to climate change and crumbling infrastructure and our incredibly destructive economic bubble-and-bust cycle, and yet we simply can't seem to deal with these things, or have dealt with them inadequately. We can collapse as a society. These guys, however, think we won't simply because we shouldn't. That's not reason enough.

No comments: