Pulling the Trigger?

The president’s health care speech last night consisted of discredited canards bookended by emotional manipulation. Between his distortions, token gestures for opponents, and lengthy bouts of tongue-lashing, Barack Obama signaled he will continue pushing forward toward socialized medicine. However, it seems likely he will move incrementally through a final bill that will nationalize health care a year after the next presidential election.

“You Lie!” Let Me Count the Ways

The bulk of his speech consisted of recycled falsehoods long since dismissed. To note the highlights, one can begin with the moment that caught everyone’s attention: Obama’s denial that “our reform efforts would insure illegal immigrants,” which provoked Rep. Joe Wilson’s response, “You lie!” (This Joe should not be confused with Ambassador Joe Wilson, an accomplished liar in his own right.)

Obama did lie. The Congressional Research Service found, “Under H.R. 3200, a ‘Health Insurance Exchange’ would begin operation in 2013 and would offer private plans alongside a public option…H.R. 3200 does not contain any restrictions on non-citizens—whether legally or illegally present, or in the United States temporarily or permanently—participating in the Exchange.” The Democrats’ plan contains no requirement that patients verify citizenship, just as the National Council of La Raza requested this summer. (Since Obama has yet to deliver on amnesty, he has to offer something.)

More egregious is his promise that nationalized health care would not result in, well, nationalized health care. ”Let me be clear,” the phrase he characteristically utters while muddying the waters. “It [the “not-for-profit public option”] would only be an option for those who don’t have insurance. No one would be forced to choose it, and it would not impact those of you who already have insurance.” A seismic change in the insurance landscape will affect everyone with insurance, and everyone who pays taxes. The Congressional Budget Office found at least 3 million Americans will move from employer-provided insurance to the public “option” by 2016, because their employers will drop their coverage.

Obama vowed, “I will not sign a plan that adds one dime to our deficits, either now or in the future.” The Lewin Group reported the House health bill would run a $39 billion deficit in its first decade, rising to more than $1.1 trillion in its second. This plan, according to the CBO, will necessitate “an average increase in premiums” for Part D consumers of 20 percent in ten years.

Not to worry: “Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan,” Obama assures us. This recalls the old liberal smear that Ronald Reagan thought there was a budget line item labeled “waste, fraud, and abuse.”

Finally, Obama insisted, “under our plan, no federal dollars will be used to fund abortions.” FactCheck.org rightly noted, “House and Senate legislation would allow a new ‘public’ insurance plan to cover abortions, despite language added to the House bill that technically forbids using public funds to pay for them.” If this is not rectified, pro-life Democrat Bart Stupak vows to kill the bill – with the help of a bipartisan bloc of 39 other Congressmen.

Playing with Blocs

Stupak’s principled coalition is one of three that has vowed to kill various proposed incarnations of the health care bill. The Drudge Report noted last night the Democratic whip counts two notable factions opposed to the current bill: Blue Dog Democrats worried about socialized medicine and leftists desirous of it. The article counts 57 leftists, including members of the House Progressive Caucus and the Congressional Black Caucus, who have refused to vote for any bill not containing public health care.

Some in Big Labor, too, have spoken out forcefully for socialized medicine. The next president of the 11-million-member AFL-CIO, Richard Trumka, said last week, “we won’t support the bill if it doesn’t have the public option in it.” This is no small threat, as labor spent $400 million electing Barack Obama last year. Trumka has vowed to take on Democrats who vote against a public option. However, Teamsters President James Hoffa and SEIU President Andrew Stern, both of the George Soros-financed labor coalition Change to Win, have proven more flexible. (CTW has more than half as many members as the AFL-CIO.) Hoffa asked for something “doable,” and on the eve of Obama’s speech, Stern appeared on MSNBC’s The Ed Show to announce his non-negotiable demands for the final bill; a robust public option was not among them. Still, any union threat to work against an already unpopular Democratic Congress during the midterm elections may prove enough to kill any bill that does not cater to their demands.

…All of which suggests a possible solution.

The Trigger Man

Although he offered a vigorous defense of the public option, Barack Obama backpedalled last night, calling it “only one part of my plan,” “only a means to [an] end, and we should remain open to other ideas that accomplish our ultimate goal.” Among these, he singled out one: “some have suggested that the public option go into effect only in those markets where insurance companies are not providing affordable policies.”

Maine Republican Olympia Snowe crafted the plan to have the government move forward with the “80 percent” of Obama’s plan “everyone” agrees on. If, after imposing hobbling restrictions on the insurance industry, “affordable” coverage does not materialize, Sen. Snowe says she can “support a public plan which is available from day one – in any state where private plans fail to ensure guaranteed affordable coverage.” Of course, the public option, however it comes about, will produce the results noted above – nationalization of health care, ultimately leading to health care rationing – but they will not be seen for years.

The trigger option is to the health care debate what Rep. Howard Berman’s plan was to Iraq withdrawal proposals: a thoughtful policy with which conservatives disagree but that is at least predicated upon measurable criteria. Thus, a centrist Democrat such as Ben Nelson of Nebraska, an opponent of the current public option, backs the idea.

On the other extreme, Rep. James Clyburn, D-SC, also promoted a triggered public option, to begin in 2013, on MSNBC last night. In the meantime, he supports establishing “pilot programs” of public insurance around the country. Clyburn’s support is significant: it means all factions of the Democratic Party can endorse this as a compromise that will result in government health insurance, moving the nation closer to Obama’s goal of Canadian-style, single-payer socialized medicine.

Although MoveOn.org has already filmed an ad against the trigger option, it seems the inevitable final destination of this “reform.”

With the current intraparty split, Obama must watch his highest legislative goal to date die a slow and public death, see that Congress sneak the government option into the final bill during reconciliation (provoking massive backlash in the 2010 elections), or pull the trigger. Of these, the third assures him maximum political coverage: government health care that begins distorting the insurance market after the 2012 election, proposed by a Republican and which enjoys “bipartisan” support.

This looks very much like our future: the slow road to socialized medicine.

This story originally ran as the lead story on Thursday, September 10, 2009, on FrontPage Magazine.