Mr. Obama, go to "China"

Todd Henderson —  22 February 2010

The president revealed his last-ditch plan to reform our healthcare system today. (Funny the plan is revealed before the “bipartisan” meeting about health care being trumpeted for political reasons.) One thing I was hoping to see in the proposal is missing — an increase in the eligibility age for Medicare (and, while we are at it, Social Security). Although I would prefer to see us do away with these entitlement programs, if we have them, why not make them solvent and sensible? When these programs were passed, people lived a lot shorter lives than they do today, and a simple indexing to life expectancy would go a long way toward reducing our national fiscal crisis. Not only would this reduce our government-funded health care expenses, it would encourage 65 year olds to stay in the work force. Take my Dad. He retired to a life of reading history books when he hit that magic number, even though he was still energetic, capable, and earning a good living at the time. Our perverse entitlement programs encouraged him to do this, to accept government handouts even though he doesn’t need them, and mandated that he go onto a government-run insurance program, even though he could easily afford his own health care bills or insurance. This makes absolutely no sense. Any system that takes people like this out of the work force and bestows upon them welfare without regard to need is not just stupid, it is immoral.

Faced with a similar set of existing incentives in the 1990s, President Clinton and a Republican Congress ended welfare as we knew it. No longer would we pay people not to work, but instead we would make government handouts instrumental toward a productive life. President Clinton had the cache and credibility with the opponents of welfare reform to get this obviously beneficial change enacted, just as President Nixon did with foreign policy hawks when he went to China. Since Democrats largely stand in the way of entitlement reform, the same must be true of President Obama. President Bush wasn’t able to reform Social Security in part because his proposal to let people invest their own money for retirement sounded to some like a plan to make Bush’s banker friends rich at the expense of Joe the Plumber. But Obama could do this. If he proposed to raise the eligibility age for Medicare (and the other entitlement programs) gradually but dramatically, perhaps in return for some Republican concessions on insurance reform and subsidies for the poor to buy insurance, there might be a deal. The Republicans might even be able to get some tort reform as part of the deal — again, who better than a Democrat lawyer to stand up to the trial lawyers?

In his best moments, the president has seemed to play against type and stand up for good ideas that are not favored by his core special-interests constituency. There have been, for instance, some nods for school choice and performance pay that have irritated the teachers’ unions. He has also continued our assault on Muslim terrorists. We need more of this from the president. (And, he needs more of it if he hopes to be reelected. Just ask President Clinton.) In short, the best hope for reform is compromise, and compromise in ways in which Mr. Obama has a comparative advantage. Anyone could ram through a one-sided agenda; it takes real leadership to go to China. Book your ticket, Mr. Obama. I hear the Great Wall shouldn’t be missed.

9 responses to Mr. Obama, go to "China"


    I don’t really disagree with much of your last post except (1) I object to your description of my last post as a “diatribe,” and (2) you ignore the fact that it takes two sides to cooperate. The President has gone out of his way to try to bring the Republicans into the healthcare reform process. They have made it clear that they want nothing to do with it and the Republican Senators have not offered a single vote in support. (I ignore the House because as it stands, Republican votes in the House are largely irrelevant.)

    I don’t believe that the Democrats have a monopoly on wisdom; for example, I think that the emphasis on healthcare insurance is a big mistake. We need a single payer system like 95% of the rest of the civilized world. But I do believe that the Republican party is “the Party of No” and I note that you did not provide any contrary evidence.

    I am not suggesting that all Republican voters fall into that category, but a significant number do, enough to provide a lot of pressure on any Republican congressperson concerned about being primaried. For a nice example outside of Congress, consider Crist in Florida. He is the sitting Republican governor running in the U.S. Senate primary against an extreme conservative Club for Growth etc candidate(Rubio). Crist is now 10 points behind Rubio in the polls because (1) he is not an extreme conservative and is therefore derided as a RINO by the conservatives, (2) he was in favor of Obama’s stimulus plan. The message that sends to Republicans is that being bipartisan or embracing Democratic proposals is political death. Thus being “the party of No” is a rational choice for any Republican interested in being re-elected or aspiring to a higher office.


    Re comment by Chris:

    There are some truisms we should all keep in mind. Name calling is a bad idea. Believing our favored political party has a monopoly on wisdom is worse, and dangerous too. Whenever I read diatribes like yours, I wonder if you really believe this “The Party of No” stuff or if it is just easy rhetoric. I guess you think the filibuster isn’t a good idea either, until Palin is elected (heaven help us) and then it will be a good idea again.

    Reagan got Bradley and lots of Democrats to help him with tax reform; Clinton got Gingrich and lots of Republicans to help him with welfare reform; Bush even got Kennedy and lots of Democrats to help him with education and Medicare policy. Whether these are socially good or bad results, I’ll leave to others. My point is simply that leadership is about creating these kinds of deals, and the president has failed to make it happen. He promised he would, but he has not delivered. If he took the approach I suggested, I think it would increase his chances or, at the very least, raise the cost of political obstructionism.


    As far as health insurance is concerned, all we hear from Republican elected officials is (1) tort reform, (2) interstate sale of health insurance. Neither of these helps increase the number of insured, which the Republicans do not care about (because their voters are, for the most part, insured). The interstate sale idea is simply another version of the rush to the bottom we got with South Dakota and credit cards. Insurers won’t be required to cover anything. In theory competition should prevent this but the antitrust exemption here (McCarran Ferguson) effectively negates that. And before we consider tort reform, why don’t we do something serious about tracking, reporting and preventing medical negligence? Maybe that would be deleterious to the income of too many Republican voters.

    If the Republicans had really been interested in increasing the number of insured, then at least one Republican in the House or Senate would have voted for the health reform legislation. Although you might be correct that there are such persons as Republican moderates in the electorate, that is largely irrelevant to the legislative process because there are no such elected officials in the Congress. They have either been voted out of office (e.g. Gordon Smith) or become Democrats (e,g. Arlen Specter). You also ignore the polling data showing that (1) the public option is very popular among people who have a favorable opinion of Obama, and (2) the people who disagree with the public option would never vote for Obama in any case.

    I agree that if the Democrats in Congress were asleep — interesting that you want them out of the loop here — then Obama could do a “bipartisan” plan with the tort reform and interstate sales elements referenced above that Republicans are interested in. That would ensure that Obama was a one-term President.

    Absent any evidence to the contrary, I refuse to believe that any Republican Senator will vote for a healthcare reform package that either increases the number of insureds or seriously regulates health insurers. Your suggestion to the contrary ignores the fact that McConnell made it clear early on that the Republican plan was to defeat any real reform so that Obama (and the Democrats) would not be able to run in 2010 and 2012 on successful and popular healthcare reform legislation. Whatever your beliefs as an individual Republican voter, the Republican party is indisputably the “Party of No.”


    Re comment by Chris:

    A couple of responses.

    First, you don’t know me as well as you think, so don’t you think it a bit presumptuous to put words in my mouth and thoughts in my head?

    Second, if you did know me, you would know I’m not a robotic vehicle for spreading ideas of Republicans. I’m in favor of such Republican ideas as gay marriage, abortion, death panels, environmental laws, drug legalization, gun control, etc. etc.

    Third, as for your political calculus, I’m not an expert, but I wonder about the advice to the president you would give: “You’ve seen your popularity among independents and moderate Republicans plummet — veer left.” I’m no Dick Morris, but that sounds like political suicide. If the president wants a second term, and it isn’t clear he does, I think the best strategy is to improve his standing among people who voted for him but don’t like him now. Seems simple, yes? These independents and Republicans (yes, many did vote for him) are not happy with his current approach. This is in part because it is not throwing any bones to the right, not moderate, not about consensus, and not measured i approach. Sure, abandoning the public option (is it dead yet?) might be thought of this way, but that is like declaring that you are going to nationalize the means of production, and then declaring it a compromise that you are only going to take over the health care industry. A real compromise would be to make progress on something like tort reform or eligibility ages, something that people in Washington think should happen but can’t say so without real leadership. The president’s mistake, in my opinion, was delegating the lawmaking to the Congress. If he went, Andrew Jackson-style, directly to the people on issues like health care, and charted a sensible middle ground (e.g., no exclusions for pre-existing conditions and subsidies for insurance for the left, coupled with tort reform and indexing Medicare eligibility to life expectancy for the right), he would have been able to lead and to be a transformative figure. Instead, he is being led by interest group pressure (e.g., union exclusion from certain taxes!) and ideological purity to a politically untenable position.

    Look, if Chris and the others who voted for Obama are happy with him having one term and turning control of Congress back to Republicans, fine by me. I doubt it will be much of an improvement, but it could be worse.


    This is not really persuasive. As a Republican, you believe that only Republican core special interests have “good ideas”. As a Republican, you believe that Obama should behave like a Republican. That way, presidential elections are meaningless because a Republican always gets elected. As someone who is politically astute, I am sure you are also aware that (1) it’s foolish for Obama to waste political capital on appeasing core Republicans who will never, and I mean NEVER, vote to re-elect him, and (2) to turn his back on the people who elected him in order to appease the people who didn’t vote for him and would never vote for him is a sure path to not getting re-elected.

    Your response to Joey is also somewhat Marie-Antoinettish: let them eat cake. Your saying that the people Joey was talking about should rely on their union pensions (if they are lucky enough to have them) is somehat ironic because I did not understand that you were in favor of unions.


    Re offline comment by a friend:

    “Why is it that people think Obama needs to be more conservative to be reelected?”

    What is conservative about encouraging able-bodied people to work, about encouraging people who can pay their own way to do so, and about making sure our country is solvent? If we cannot all agree that my Dad should not be sitting home right now reading a biography of Eisenhower and waiting on his Social Security check to arrive, then I’m afraid we are in worse shape than I thought.


    Re comment by Joey:

    This is the standard response to my unoriginal proposal. I agree that there may be people who cannot work in particular jobs for longer than a certain number of years or beyond a certain age. One question is how many people like this are there? As the economy has moved from manufacturing to service, I’m guessing the number is less than it was when these statutes were passed. Even assuming there are people like this, we aren’t done. Is it really true that these people aren’t getting private benefits to account for these factors? We observe certain fields in which the labor bargain includes generous private benefits, such as pension plans, that are designed to offset this problem. Union contracts, for instance, often take this into account. But I will go further. Is it really the case that our model of labor in this country is that you train for one job and that is what you do for your life? I think the evidence suggests otherwise. Plenty of productive workers transition many times during their career. Is it true that you can’t shovel coal into your 70s? Probably yes. But does that mean you can’t work at Wal-Mart, as a salesman, as a teacher, as a carpenter? I see plenty of older people in the labor force, not all of them are former CEOs. To be sure, there will be some people whose bodies and minds simply give out after a certain age. But these should be handled on an individual basis. The exception, however big it is, should not drive the rule.


    I support your broad idea that we should raise the retirement age, but remember that raising the age is not that simple practically, let alone politically. Many people are in physically demanding professions where they can’t keep working into their late 60s or early 70s: construction, firefighting, security, for example. And while it’s impolitic to say, most blue-collar workers have less education, and that correlates to more healthcare problems, especially later in life. After 45 years of labor these people will be too tired or too incapable to work at their old jobs, too unskilled to be trained to do something else, and too unhealthy to afford private-market health insurance.

    What do we do with these people? I don’t know. We can say ‘Let ’em get back to work!’ until we’re blue in the face– but that’s irrelevant to the problem that they cannot get back in the work force.

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