Health care, Dems' kamikaze mission

Author: Sen. Lamar Alexander

Posted on December 18, 2009

There’s been a lot of talk lately about “making history” on health care. The problem is, there are different kinds of history. In this case, the Democratic majority seems determined to pursue a political kamikaze mission toward a historic mistake. If it succeeds, the result will be disastrous for Democrats in 2010 and, unfortunately, even worse for our country.

But this wouldn’t be Congress’s first historic mistake.

The Smoot-Hawley Tariff of 1930 to “buy American” sounded like a good way to protect jobs by keeping out cheaper foreign products. Historians agree it was a mistake, setting off waves of retaliatory tariffs and making the Great Depression worse.

The Alien and Sedition Act of 1798 sounded good, too. The idea was: Let’s protect the county from enemies in our midst (then, mostly French) by making it a crime to publish scandalous writing. That turned out to be another historic mistake, encouraging more protest and violating our traditions of free speech.

In 1969, Congress enacted the “millionaires’ tax” to catch 155 rich Americans who paid no taxes. This year, this alternative minimum tax caught 28 million taxpayers — before Congress passed another one-year patch to fix it.

More recently, there was the Catastrophic Coverage Act of 1988 to help seniors deal with financial losses. Trouble is, seniors resented paying for it. An angry crowd surrounded the chairman of the House Ways and Means Committee in his home district. Congress repealed this historic mistake, and the leader of the angry seniors is now a congresswoman from Illinois.

Then, in 1991, there was the “luxury tax” on boats costing more than $100,000. This turned out to be another historic mistake. It raised only half the projected $31 million in revenue while nearly sinking the domestic boat industry and costing 7,600 American jobs. A chastened Congress also repealed that one.

Rather than make history of this sort, Congress should learn from history. Slow down, take a deep breath and get it right. On Monday, California Gov. Arnold Schwarzenegger offered this advice concerning the current health care bill: “So I would say, be very careful to the federal government before you go to bed with all this. Let’s rethink it. There’s no rush from one second to the next. Let’s take another week or two and come up with the right package.”

Schwarzenegger, like almost every governor, is worried about new costs imposed on states by the health care bill’s expansion of Medicaid. “This last thing we need,” he said, “is another $3 billion of [state] spending when we already have a $20 billion deficit.” Tennessee’s Democratic Gov. Phil Bredesen has called this Medicaid expansion “the mother of all unfunded mandates.”

No one doubts that Democratic members of Congress sincerely want to improve health care. But they are biting off more than Congress can chew. It is historic arrogance to believe that we in Congress are wise enough to take an entire health care system that involves 17 percent of our economy and serves 300 million people and know how to fix it all at once.

The one thing we can be sure of is that if this bill should pass, the law of unintended consequences will produce unwelcome results from higher taxes, higher premiums, Medicare cuts, an increase in the federal debt and large new costs passed on to struggling states. For example, the Medicaid expansion will surely increase state taxes or college tuitions, or both.

There is a better approach. Instead of trying to change the entire system, we should set a clear goal — reducing costs — and go step by step toward that goal to re-earn the trust of the American people. Republicans have suggested that the first five steps should be: allow small-business health plans that would permit smaller companies to pool their resources to offer health insurance; reduce junk lawsuits against doctors; allow competition for insurance across state lines; encourage wellness and prevention; and attack waste, fraud and abuse. We have offered legislation to take each of these steps. Once we take these steps, we could then take five more.

And what if Congress, in trying to fix everything at once, gets it wrong? Rushing back to fix the health care sector again because Congress made another historic mistake won’t be nearly as easy as repealing a boat tax.

Sen. Lamar Alexander (R-Tenn.) is chairman of the Senate Republican Conference and a member of the Senate Committee on Health, Education, Labor and Pensions.