Wednesday, January 20, 2010

The Cost of Overthinking

No I’m not talking about overthinking the reasons for or the implications of the Coakley loss, there are plenty of others doing that and I’m not eager to get lost in that crowd. I have a theory about why Democrats are losing ground, and it involves overthinking.

Two major legislative efforts have been issues so far under Democratic control of our government this go around; economic stimulus and health care reform. Both bills have been debated at great length, and have attempted to deal with every aspect even peripherally related to the central theme of the bill. In both cases the end result was, after a contentious and ugly process, creation of a monstrous and massive bill that the public did not understand and did not like.

Bush and the Republicans crafted legislation that was, for the most part, rather limited in scope (and unfortunately sweeping in effect, but that’s a different issue), with each bill being limited narrowly to the purpose it was intended to achieve. Hundreds of peripheral items and riders were often added, of course, but they were the run-of-the mill pork barrel spending that doesn’t merit discussion by Congress or the media. Once in a while social policy would be added to a war spending bill; the bill would promptly be voted down and a new bill introduced and passed that did not contain the social policy.

Medicare Part D was a massive spending bill, one of the biggest ever, but it was rammed through fairly quickly and without all that much controversy. (It seemed like a lot at the time, but pales to insignificance compared to what Democrats have managed to generate.) In part that was because it didn't contain anything other than Medicare Part D. The Republicans didn't use this massive bill as a platform to make sweeping changes to everything about Medicare; it focused on the one central idea of securing payment of medications for seniors.

Democrats come up with a basic idea of stimulating the economy. The initial idea was to create jobs, but then they create a bill that attempts to accomplish that and much more, and it makes that effort by doing several hundred different things, none of them on a really major scale that can be pointed to as central to the bill. Consequently they have a “stimulus bill” with no signature item, nothing that the public can identify with and really get behind. The initial idea of creating jobs got lost in the morass of this massive bill, and the end result is that the only “big thing” about the bill is the dollars spent.

Now they are saying that the stimulus bill did create jobs, but unemployment is still increasing and they cannot actually show the jobs that were created; can only claim that it would have been worse without the bill. Maybe so, but if the bill had been about roads and they could point to the new roads, for instance, they would be in a lot better shape.

They have approached health care reform much the same way, diverging from the initial issue of insuring the uninsured and providing no central issue that the public can really get behind and support. Look at all the issues that Democrats are touting as attempting to resolve with this monstrous bill; insure the uninsured yes, but then they have added; reduce the cost of insurance, lower health care cost, keep everything the same for people who like what they have, lower the cost of Medicare, eliminate waste in Medicare, not change Medicare, expand Medicaid, reform the way health insurance is administered, reform the delivery of health care, computerize health care records, hold health insurance accountable… The list is almost endless. Again, the initial idea of insuring the uninsured got swallowed up in the process, and the one thing that is clear is that the cost is very large and we have their promise that money will be extracted somehow, from someone, to pay for it. The cost is very clear, the method of payment is much less so.

Health care reform is going to do the same thing to them that the stimulus bill did, if it passes. People are going to want to know why the cost of health insurance is still rising, and Democrats are not really going to be able to point to any specific and tangible thing that this legislation has actually done.

But the money spent for both of these bills will be highly visible.

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