Health Reform the American Way

We vaunt American democracy as a stellar model for the world. The bizarre spectacle now on display in Washington as the White House and the Congress tussle over health care "reform" is hardly an advertisement from our prime export product. Consider the following. The nation's entire medical system is being reshaped by six Senators meeting behind closed doors for weeks. All we know of the proceedings is through puffs of smoke leaking under the doors. The other 529 members of Congress twiddle their thumbs awaiting the conclave's outcome. The gang of six composes three Republicans and three Democrats from states that cumulatively contain less than 3% of the country's population. All are more conservative than the large majority of Democrats who control 60 Senate seats and much more conservative than most Democratic Representatives in the House. They have just killed the "public option" that is favored by 72% of the American public. They have also rejected out of hand the provision for financing the costs of the program via a tax on the rich as approved by the key committee in the House. So, too, for the Employer Mandate that has been at the heart of all serious proposed plans until the gang of six decided otherwise.

Where is President Obama in all this? Supposedly he is investing himself and his political capital in a full court press to win support for his epochal program. But the White House cannot say at this eleventh hour just what he wants in the program. A "public option" or not? An employee mandate or not? A tax on the super-rich or not? No one knows. Yes, we can do what? Obama is out there making the case for a phantom program. All we can be sure of is its complexity, a complexity that defies comprehension -- much less reasoned assessment of what it would mean in practical terms. Somehow, a brilliant President and the assembled powers of the United States Congress are together concocting something that makes Rube Goldberg look like a minimalist. One cannot avoid the conclusion that the current model of American government needs some redesign before it can capture foreign markets.