Entitlements Are Never Repealed
This is what allows historic legislation to become historic — it achieves broad support, is passed without parliamentary tricks, and becomes the broadly accepted law of the land. Tomorrow’s vote — even if House Speaker Nancy Pelosi squeezes out 216 Democrats to pass the legislation — will not be historic. It will not “end” a century-long struggle over health care. The issue will be revisited in November 2010 and in the next Congress and in November 2012.
And I predict the great majority of what passes tomorrow — if it does, and that’s by no means a given — will never become settled law or public policy. Instead, its passage will intensify a great debate over the size and scope of government that could well result in public policy, in health care and other areas, moving, in the coming years, in the opposite direction. ~Bill Kristol
One might note at this point that Kristol has an unusually bad record of predicting things, and he has probably just added to his already extensive list of wrong guesses. One of the major problems we face as a nation is the complete inability to dismantle an entitlement once it is established. Every entitlement typically creates a constituency that benefits from it and is forever dedicated to its defense. The most electorally significant resistance to the current legislation has come from Medicare loyalists who wish to preserve it just as it is, and it may be that even this is not enough. While Republicans have been able to tap into the fear that Medicare will have to be cut, a repeal effort will tap into a much smaller electoral base that never wanted health care legislation of any kind passed.
A better argument against comparing the health care bill with the Civil Rights Act is that from a liberal perspective the latter was the correction of a systematic injustice being done to a large number of citizens. As its supporters saw it, it was an attempt to secure civil rights that these citizens should have had all along. While some progressives may see health care in similar terms, there really is a major difference in legislating to end state-sanctioned denial or curtailment of civil rights for some citizens and creating federal legislation that effectively grants a right that a large portion of the country doesn’t think exists for anyone.
Large-scale change naturally provokes anxiety, uncertainty, fear and resistance, which is inevitable and as it should be. It does not follow that the later backlash against large-scale change will be great enough to undo the change. The Medicare prescription drug benefit was not passed by large margins in the House, and its eventual passage was the product of some significant arm-twisting, maneuvering and vote-buying. It was also unfunded and therefore incredibly fiscally irresponsible! It was phenomenally bad policy! That doesn’t mean that there has been a groundswell of outraged voters ready to support its repeal. As far as I know, no one on the mainstream right, least of all the editor of the magazine that once championed big-government conservatism, has even proposed repealing it. After all, it is their monstrosity. It has become part of the structure of our unsustainable, disastrous entitlement system, and no politician with any self-preservation instinct would so much as suggest eliminating a benefit that millions of likely voters enjoy receiving.
Kristol’s discussion of the Civil Rights Act is quite amusing. He mentions that it received substantial support from both parties, but seems disinclined to acknowledge the ideological diversity that used to exist in both major parties. To oversimplify a bit, conservative and Southern Democrats and some conservative Republicans voted against the Act, while Northern liberals and moderate-to-progressive Republicans voted for it. There were significantly more of the latter. Obviously, there was enormous dissatisfaction with the passage of the Act among Southern Democrats and many conservatives generally, and this led to a significant flight of Southern Democrats to the GOP banner, at least as far as presidential elections were concerned, that was followed in the last twenty years by a movement of Southern Democrats towards Republican candidates for Congress as well. There was tremendous backlash to and resistance against the Act and its implementation. Everyone knows this. Despite the backlash and resistance, there has been no successful movement for its repeal. Indeed, were such a movement ever to emerge we can be fairly sure that Bill Kristol and his allies would be among the first to condemn it. Since the above-mentioned realignment, the parties have tended to become much more ideologically uniform, which has made debates over large-scale social legislation into much more straightforwardly partisan struggles. One could no more have broad bipartisan support for major pieces of legislation today than one could summon up the old traditions of Congressional comity and bipartisan cooperation. These were products of an era when ideological and partisan lines matched up much less frequently.
Of course, it could be that health care legislation will not create a big enough entitlement that benefits enough people to secure it against the inevitable backlash, and it could impose enough costs on other blocs of voters that they would react strongly against it and support a repeal movement. However, whether or not this will happen is tied up with the substance and effects of the legislation, which Kristol does not bother to discuss at all. He is concerned entirely with process and the size of the majorities in Congress that support the bill. These tell us nothing about the nature or extent of the political backlash to the legislation, and they also tell us nothing about the effectiveness of that backlash in repealing the measures contained in the legislation.
32 Responses to “Entitlements Are Never Repealed”
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This begs the obvious question: where were Bill and this critique over the past 12 months? Spreading mendacious rumours and refusing to engage with the substance of reform. There was always a principled case against health reform but we heard precious little of it from the GOP and their institutional boosters.
As the main function of the government becomes delivering entitlements and since entitlements can never be cut, reduced, or rescinded, they what purpose does the Republican Party serve.
AS the U.S. becomes a one party state, the real question will be how the U.S. generates enough economic activity to produce the tax dollars needed to fund the welfare state.
My guess is that there will come a time when the U.S. will not be able to tax and borrow enough to fund all of the entitlements that cannot be reduced or cut.
Entitlements are like herpes. Once you’ve got one, you’ve got it for life.
That’s why the Kuciniches of the world, who know it’s a horrible bill, will vote for it. Eventually they’ll get centralized, bureaucratized medicine, and a dispirited nation living in the equivalent of council housing.
Entitlements can and have been cut. Welfare Reform comes to mind. And for all the caterwauling, entitlements are very difficult to pass. Health care reform has been on the docket since at least Eisenhower. It is little surprising that things very expensive things that are difficult to pass are subsequently difficult to be repealed. It isn’t like the problems the beneficiaries faced weren’t real and wouldn’t be real once again were repeal to occur.
BTW, a lot of protest has been coming from people who pay little to no income taxes to begin with and won’t be paying them significantly after the reform either. Opposition is almost completely ideological and not driven by personal interest.
In order to scale back entitlements, you may have to bribe elements of the lefty coalition:
http://www.themonkeycage.org/2010/03/learning_the_hard_way_the_marc.html
Kristol is correct when he says that the bill’s passage will intensify debate over the size and scope of government. More sound and fury signifying nothing because both sides have grown used to taking their turn on the same animal and are not about to weaken it.
Whatever good results from this bill, it is sure that it will be accompanied by confusion, bureacracy, and accelerated erosion of esteem for the medical profession. Government as an institution will remove itself a few steps even farther from the regard of the people, but so what, the Beast will be fed and will grow.
The remarkable thing, and testament to how horrible this bill probably is in its incoherence, is that it has enabled the Republican Party, utterly discredited as representative of limited government, to re-don its mask.
One problem is the majority of Main Streeters who are self identified conservatives are not small government conservatives at all but actually like all the entitlements – they just don’t like paying for them.
“Despite the backlash and resistance, there has been no successful movement for its repeal. Indeed, were such a movement ever to emerge we can be fairly sure that Bill Kristol and his allies would be among the first to condemn it.” An excellent point. Kristol speaks not as a conservative, but as a fellow leftist.
I suspect that somewhere down the road the total burden of government will force some retrenchment. But by that time there will be no principled arguments supporting retrenchment just practical agreement among varying degrees of statists, as is the case of Sweden or Austria.
“One of the major problems we face as a nation is the complete inability to dismantle an entitlement once it is established.”
First, a question, which entitlements would you wish to be dismantled?
In any case the statement is off. One of the major problems we face as a nation is the complete inability to pay for the entitlements we demand to be established. And this doesn’t mean raising taxes necessarily, but that would work too. Cut our defense budget by 25% and the unfunded entitlement problem would go away.
Finally, don’t forget, health insurance reform will reduce the long term deficit. It doesn’t cost money, it saves money.
Which do you prefer to buy, the swampland in Florida, or the pretty bridge to Brooklyn?
“First, a question, which entitlements would you wish to be dismantled?”
Alphabetical or chronological?
Let’s start with farm subsidies and federal educational spending, and move on from there. Let’s not forget the many indirect entitlements out there that serve as both social engineering and vote buying: subsidized student loans, mortgage interest deductions, single industry tariffs, etc.
Mr. Larison is completely correct in his assessment regarding the repeal of entitlements for a simple reason: the beneficiaries have far more to lose than the individual taxpayers have to gain by repealing the entitlements. The classic mohair subsidy lasted for decades because it was barely a rounding error on the budget. To those who received the subsidies, they may have been an important portion of their income. To the taxpayer, it was pennies per payer. So whenever the subject of its repeal came up, we can guess who called their Congressmen.
What is most worrisome about this legislation is that is obviously a trojan horse. It is a terrible bill from both side’s point of view. And this fact will be used a few years from now to say, “this program was a good start, but costs are still rising, and it isn’t effective enough. What we really need is MORE government intervention to make sure it really works this time.”
This is why a principled (not merely practical) defense against entitlements is so important. It’s not just a health care bill, it’s a complete perversion of what our federal government was designed to do. Unfortunately, few Republicans in Congress are intellectually prepared to make that case effectively.
Peace be with you.
Norwegian Shooter: also, to be fair, I completely agree that we need a reduction in defense spending, too. I’m still waiting for that peace dividend…
“Which do you prefer to buy, the swampland in Florida, or the pretty bridge to Brooklyn?”
This reform effort may not do the trick, but the fact that other post-industrialized nations manage to provide perfectly acceptable health care WITHOUT driving themselves into bankruptcy would argue that there are reforms to be made that would save money.
And I’ll believe the GOP will vote to repeal this reform when I see a Republican Congressman explain on TV why insurance companies should be allowed to deny coverage because of pre-existing conditions. That’s the fundamental change here, it’s supported by an overwhelming majority of Americans and if you try to undo reform without touching it, you’ll only end up producing an even bigger disaster than this reform could ever be.
Mike
To amplify on Norwegian Shooter:
Silly me. I thought a democratic government is supposed to create and defend entitlements demanded by its citizens. I guess Daniel would prefer it if our representatives did not do this. Got it.
And I’ll believe the GOP will vote to repeal this reform when I see a Republican Congressman explain on TV why insurance companies should be allowed to deny coverage because of pre-existing conditions.
You make the mistake most Liberals make in confusing “insurance” with “government medicine”. Insurance is the business of risk management through risk dilution. If you have a pre-existing condition, you are not “at risk” of contracting the condition; you already have it. Therefore, no insurance company would (or should) cover you for that condition anymore than anyone should offer fire insurance for a house that has already burned down.
Insurance only functions as a private enterprise subject to competitive constraints and the rule of law. The real issue on this score might be the reported cases of insurance companies finding loopholes to renege upon their commitments to patients who were unfortunate enough to come down with the disease for which they were legitimately covered. Again, this sort of abuse is kept to a minimum if insurance companies cannot induce the government to suppress competition and protect them (a big if).
As for government-health. Mike is deluded if he feels an American National Health Service to be a good solution to our mess. I do not agree with Larison that it is impossible to repeal this entitlement, however. This bill, combined with Obama’s messianic fixations, will cause more short-run havoc than long-term complacency, as the health industry is quickly massacred and incorporated into the Leviathain; and I’m expecting more to come from him on this score. Look for Obama to reintroduce the concept of repeal to the political classes. It might not be repealed, but it has a better shot of doing so than almost anything else.
“This reform effort may not do the trick, but the fact that other post-industrialized nations manage to provide perfectly acceptable health care WITHOUT driving themselves into bankruptcy would argue that there are reforms to be made that would save money.”
This is the point I’d be most interested in hearing a truly principled refutation of. The apocalyptic fury that has characterized opposition to healthcare reform in the US would be understandable if the administration were proposing blowing up the moon, instituting a one-child policy, launching an unnecessary and ruinous war, or cancelling the Super Bowl. If someone could point to an example of a country where introducing a public healthcare/insurance program was a disaster, then I would be willing to consider reasons why Americans shouldn’t be trusted with the kind of system that most of the rest of the industrialized world takes for granted.
“You make the mistake most Liberals make in confusing “insurance” with “government medicine”.”
You make the mistake of confusing your ideological pontificating with what goes on in the real world. Prohibiting insurance companies from discriminating against people with pre-existing conditions is spectacularly popular with the public. Politically speaking, that’s all that matters. GOP elected officials are not going to stand before the voters and say, “I think insurance companies should be allowed to deny you coverage because I think their profits are more important than your lives”.
Which is what makes the ban on pre-existing condition denials so important. If you prevent insurers from doing it, they can no longer fuction properly as risk managers. That’s why you have to do all the other crap involved in health care reform. You can’t take away all the other crap and leave the pre-existing condition ban in place, and no one’s going to repeal the ban. Ergo, no one’s going to repeal any other significant aspect of health care reform.
And frankly, someone who’s not bright enough to recognize that this is probably the last, best chance at preserving anything that resembles the current private health insurance industry in America probably shouldn’t be inpugning the level to which others understand this issue.
Mike
rbc,
Conservatives lost the argument when the let the left define insurance as something that someone else pays for and that the someone shoul be the taxpayers.
The left is running around believing they are getting something for nothing. What Europe gets for its health care system is taxes above the 50% rate and growing at the point that there will soon not be enough people in Europe to pay the taxes to fund for the citizens to receive all of the benefits that they have promised themselves.
In addition, the Democrats are pushing for open borders an unlimited immigration while growing the welfare state. Something has to give and the first thing will be compliance with the law. Tax cheating will increase when the Democrats raise taxes to pay for all of the entitlements.
The problem with this bill is that it combines the vices of capitalism and socialism. It will enhance centralization and bureaucracy while forcing citizens to become customers of the insurance oligopolies, and in many cases to buy coverage they neither want nor need. Note that the anti-trust exemption for insurance companies remains in tact, and there is no provision allowing for the sale of policies across state lines. Soon enough, the automatic Medicare reimbursement cut will be postponed again, increasing the cost of the plan substantially.
Demand for health care is highly price-elastic, and so insuring 35M more people will result in substantial additional demand, continuing the upward pressure on costs, with little or no provision for increasing the supply.
Of course, once people have the benefit, they will want it increased. Here come the alternative practitioners, the disease lobbies, and cultists of all kind, demanding coverage for their services, diseases, and nostrums. Then, in turn, will come the inevitable rationing because we can’t pay for all the health care people will want if it’s free–and Bloomberg-style supervision of our lives to prevent us from doing anything immoral, fattening, or fun.
Soon we will all be on endless queues, filling out endless forms, while we are ignored and maltreated by swarthy bureaucrats whose English is as unintelligible as their arrogance and contempt are clear.
One thing Daniel did not mention is that Kristol was for amnesty for illegals. If Kristol had his wish granted in 2006 millions of illegals would now be receiving Medicaid. Whether it is amnesty for illegals or drugs for seniors Kristol does not care about the federal budget. He cares about getting votes for the GOP.
cfountain,
Good rejoinder.
I was just thinking of the biggies, SS and health. I’m with you on farm, mortgage interest deductions, and single industry tariffs. However, the dollars involved just don’t make much of a difference. More enforcement of tax shelters and the like would raise the revenue needed.
“It is a terrible bill from both side’s point of view.” If you’re talking about the edges, yes, but that’s the case for all passed bills.
“It’s not just a health care bill, it’s a complete perversion of what our federal government was designed to do.” I can’t go with this originalist view. Argue the policy points, not the intent of the founders. Btw, I hope you agree that taking away an enumerated Constitutional power (Congress’ right to declare war, for instance) is more perverse than Federal legislation addressing topics not explicitly enumerated in the Constitution.
“Silly me. I thought a democratic government is supposed to create and defend entitlements demanded by its citizens. I guess Daniel would prefer it if our representatives did not do this. Got it.”
Thanks, but actually no. Wrong on two counts. First, we do not have a democracy; we have a republic. Second, the powers and purpose of federal government are designated in the US Constitution; you will find no mention of health care or anything like it there. I do not ask my GA Congressman to go to the DC slot machine and beg for my ‘piece’ of the nation’s wealth. If you want government sponsored health care, either a.) ask for it from your state house or b.) demand an amendment to the Constitution guaranteeing American citizens the right to demand services from a medical provider of your choosing.
“And I’ll believe the GOP will vote to repeal this reform when I see a Republican Congressman explain on TV why insurance companies should be allowed to deny coverage because of pre-existing conditions.”
Oh, they’ll take you with your pre-existing conditions. But be warned that they will also charge rates commensurate with the estimated cost to do so over the lifetime of the condition, as is their right and their fiduciary duty. The metaphor provided earlier is apt: it’s like trying to buy fire insurance on a home that’s already burnt down.
“This reform effort may not do the trick, but the fact that other post-industrialized nations manage to provide perfectly acceptable health care WITHOUT driving themselves into bankruptcy would argue that there are reforms to be made that would save money.”
Part of the reason these countries have been able to do so without destroying their budget is because they have been able to spend inordinately less on defense, while we continue to pay an inordinately large amount. Once/if this imbalance is rectified, they will have some tough choices to make.
The additional costs are just gas on an already out-of-control $55B debt inferno. Rationing, food-specific taxes, fewer doctors, even less incentive to develop drugs for rare diseases; these and who knows what else are on their way. And, when this public/private amalgamation fails to deliver the cost savings that they expect, the ‘obvious’ answer is to cut out the private part. (oops…ouch!)
Peace be with you.
Thanks Norwegian.
“It’s not just a health care bill, it’s a complete perversion of what our federal government was designed to do.” I can’t go with this originalist view. Argue the policy points, not the intent of the founders. Btw, I hope you agree that taking away an enumerated Constitutional power (Congress’ right to declare war, for instance) is more perverse than Federal legislation addressing topics not explicitly enumerated in the Constitution.”
Umm, why can’t we go with originalist point of view? Do words really have no meaning? Is the law truly unknowable? In what parts of the Constitution are we to follow their intent, and what parts are we to ignore? Shall we also dispense of rights to free speech or religion while we are at it? The unique purpose of our Constitution was to say to our leaders: “These are your powers: everything else is for the states or the people.” And, yes, I agree completely that the Congress’s right to declare war is an integral part of the document, and has been neglected for far too long. One situation (health care) cedes to the government powers it does not have, while the other (war power) removes legitimate powers that it does maintain. I view them both with equal disdain.
If in any case, if indeed this enormous change to a large part of our nation is so necessary and so justified, an Amendment should be a slam dunk, right?
Peace be with you.
, “I think insurance companies should be allowed to deny you coverage because I think their profits are more important than your lives”.
Yeah Mike. “People over profits!” “Capitalism is Racism!”.
But Mike’s offensive, histrionic, and astoundingly ignorant sloganeering aside, insurance is a word that has a meaning. It means protection against risk. Mike continues to use the word “insurance” inappropriately when he means “cost transfer”. The two are different. It is quite literally the difference between paying for life insurance and having the government pay for your funeral, which is what this legislation effectively does to the US. The relevant ethical issue with insurance companies is breach of contract. Do you get what you pay for or does the company find some squid ink to drop you once you get sick even if you were insured? It is not, why doesn’t the mean company insure me for my pre-existing condition. BECAUSE IT IS A CONTRADICTION IN TERMS.
Once you have the difference between cost transfer and insurance down, you can get to the chain reaction that necessarily will accompany the legal mandate to “insure” people with pre-existing conditions. You see, Mike, this had to be accompanied by the legal mandate for the citizen to buy health insurance as a prerequisite for living in the US, otherwise, the costs for those WITHOUT pre-existing conditions would have to cover THEIR risk PLUS the CERTAIN DEADWEIGHT COST (again, not risk) of the sick.
Please be aware of the technicality that these two items are flagrantly unconstitutional. Then understand that once we have the mandate to buy health insurance in place, one of two things happens. One, if Obama is serious about the mandate and legislates stern penalties for those who are noncompliant (let us rename the country the United States of Compliance, huh Mike?) then this will amount to a tax from the healthy to the sick with the insurance company raking it in as the middleman. The entire plan is then a transfer of wealth from healthy people to sick people and insurance companies (and to the government in the form of penalties.)
The other possibility is that Obama isn’t serious about the mandate. Then what happens is that since the health industry must take you after you are sick, nobody buys insurance until they get sick, at which time they sign on to the transfer program. (This might clear up the difference between the two if you’re still struggling.) Then the reverse happens. “Insurance” companies then have to lose massive amounts of money in every transaction. Since no one in this framework will ever have an incentive to engage the insurer in any transaction profitable to it. The insurer goes out of business. (People over profits, right mike? Or do you want to mandate the insurer to stay in business while losing trillions? Perhaps, the way the president thinks, a fine of 400 pesos will do the trick.)
The obvious and inescapable result is single-payer.
Mull that over for a bit, Mike. Insurance companies provide a service, and while they can be evil sometimes, if they are subject to a competitive environment, they ultimately must seek transactions that work for the mutual advantage of the insurer and the insured. Since both actors act freely, one assumes mutual benefit. Now that you have free action replaced by mandates in every turn, there is no mechanism to support productive transactions. At one point we had the choice of buying nothing at all, which at least forced the insurers to provide SOMETHING worth parting you from your money (which means again that it was for mutual advantage). Now, you are forced to buy. Imagine what’s going to pass for health care when you don’t have the option of not getting it. Money for nothing, Mike. I guess it can be done after all.
The federal government’s power to regulate interstate commerce has already been interpreted in such a way as to allow the government to do pretty much anything involving commerce in any way:
http://en.wikipedia.org/wiki/Wickard_v._Filburn
Now before y’all go around declaring the imminent demise of the Republic for some politically volatile bill on the grounds of unconstitutionality, you may wish to consider the decades of precedent.
Is encroaching power of the federal government a problem? Yes. Is this bill problematic for dozens of reasons? Oh yes. But bear in mind that and other Supreme Court decisions rendered your “unconstitutional” arguments legally invalid almost a century ago. Not just today.
Rowan, yes that has been their interpretation for some time. However, two things:
The Supreme Court’s decisions are not immutable, and I’m sure we know of instances where long held interpretations were overturned (corrected?). As I recall, this happened rather recently.
Second, since we are not allowed to purchase policies from other states, how is this “interstate commerce?”
Peace be with you.
I’m looking for the constitutional amendments positing that the federal government regulate drugs, our food and water supply, environmental protection, education, establish antitrust and communications standards, immigration standards, finance research, infrastructure improvements, ban child labor, etc.
Well, then! Unconstitutional!
cfountain, I’ll only be peaceful when you admit my position!
What beej said. Do you want an alphabetical or chronological listing of Federal government legislation addressing non-enumerated powers?
OK….let’s try this another way. Are there ANY Constitutional limitations to government power that either of you feel should be respected? For instance, if Congress rolls up today and decides that, “In order to reduce the impact of money in politics, we’ve passed a law extending our terms to 10 and 15 years respectively,” is this also Constitutional to your mind?
The items you mention are, in most cases, desirable, but that does not inherently mean they comport with the limitations of our founding document. The rationale that says “I want it, so it’s ok,” is not materially different from the way Bush/Cheney/et. al. also treated that “damn piece of paper.”
Peace be with you.
See Daniel’s latest for my side. Last paragraph.
I’m saying this again, there is a big difference between abrogating an explicit statement of the Constitution, like terms of office, and legislating on topics not specifically enumerated in the Constitution. First, unconstitutional, second, not unconstitutional.
I’m saying this again, there is a big difference between abrogating an explicit statement of the Constitution, like terms of office, and legislating on topics not specifically enumerated in the Constitution. First, unconstitutional, second, not unconstitutional.
No, rather, first, harder to get away with, second, easier to get away with.
Put another way, the fact that some of Bush’s violations were more blatant does not make them more unconstitutional. To the extent he got away with it, his claim that he acted constitutionally is as valid or invalid as the claim by Democrats that health care is invalid.
i aggree with the above If the insurance coy ceded the riks to facultative abroad.