By Greg Scandlen, Director of the Heartland Institute's Consumers for Health Care Choices
Previously, I wrote an op-ed defending Sarah Palin's concern about "death panels." Certainly her expression was shocking and designed to get attention. It succeeded extremely well in that regard. The case I tried to make was that, if we follow the British model, we will indeed end up with a federal agency that makes life-and-death decisions for all of us based on a cost-effectiveness standard.
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I got some amazing responses to the op-ed. Almost everyone who contacted me agreed and thanked me for saying it, but most interesting was the intense hostility from academics and policy wonks. You would think I had kidnapped their baby or something. I have never seen such a visceral reaction to any issue in health care.
Maybe it was Palin Derangement Syndrome, but I think it is deeper. I think these folks are completely baffled and frustrated by what is happening. It is all slipping away -- yet again!
How can this be, they wonder. We have big majorities in the House and Senate. We have a smooth talker in the White House. We have bought off the special interests. We have learned from the Clinton mistakes. We have done everything right. How can we be losing again?
There are two big reasons.
First, they believed their own propaganda. For years, these folks have cherry-picked the data and exaggerated the problems to make it seem like there is a BIG CRISIS! They did this to justify changing American health care from top to bottom and gain more power for themselves. That is fine as a tactic. It's a way to stampede less-informed people, especially the media, into echoing your talking points. But if these folks actually believed it, they are bigger fools than I realized. People have been talking about a CRISIS in health care since the 1960s.
In a remarkably candid interview in 2001, Brandeis economics professor Stuart Altman said, "When I was 32 years old, I became the chief regulator in this country for health care. At that point, we were spending about 7.5 percent of our GDP on health care. The prevailing wisdom was that we were spending too much, and that if we hit 8 percent, our system would collapse."
Obviously the system did not collapse, even though the share of GDP now exceeds 15 percent, and the fear mongers were proven to be blowing smoke. But that didn't stop the exact same people from pitching the exact same line every year since.
The other reason is that the current advocates completely misread the lessons from the Clinton years. Every generation of new parents swears it will not make the same mistakes their own parents made. So they make a bunch of new mistakes instead. So it is here.
The advocates have convinced themselves that Clinton was defeated by a small cabal of Washington special interests who spent a lot of money opposing the plan. They figured if these special interests could be neutralized, it would be clear sailing. Plus they figured Clinton's big mistake was in writing a massive bill in secret with little Congressional participation, so if they let Congress write it, everything would be okay.
They were wrong on both counts. In fact in 1993-1994, there was the same kind of grassroots fervor there is today. People in Washington didn't notice it. They noticed only what the special interests were doing, and they assumed any grassroots concerns were orchestrated by these special interests. Not true then, and not true today.
On the second point, the issue isn't who wrote the massive bill in secret. The issue then, and today, is that a massive bill was written in secret at all. The folks don't care if it is written by a Congressional elite or a White House elite. The simple fact that any elite group is massively changing everything about their personal health care with the sweep of a pen is enough to raise alarms.
Every time over the past 100 years that Washington has tried to enact massive health reforms affecting every man, woman, and child among us, it has been defeated. Not by the insurance companies and not by the doctors, but by the people of America. It is, quite plainly, not how we want change to be done.
Yes, we may want change to happen, but we want it to be gradual, so it can be revised and amended as we go along. Why is that so hard to understand?