If I were an editorial cartoonist, I’d depict Harry Reid and Nancy Pelosi as Tarzan and Jane, swinging through the forest, dangling a ragtag bundle of Congressional Democrats in a net trap, eking their way from one tree to the next as each vine snaps behind them, nearly sending them to their death in the jaws of lions below.

Here are a few of the nine lives Congressional Democrats have used up in recent months:

(1)    The House version of the health care bill passed in a squeaker of a vote, 220-215, three weeks ago.  Two Democrats voting the other way would have killed the bill (not 3, since Republican Representative Joseph Cao cast his vote for the bill only once he was sure it would pass without him).

(2)    The Senate agreed to begin debate on its version of the bill in another squeaker of a vote this weekend, which was preceded by a $300,000,000 payoff to Senator Landrieu for her state of Louisiana (thanks for the revised figure, Mary!).  As Dana Milbank noted, this sum is 20 times the price of the original Louisiana Purchase, which bought us 14 states.  As The New York Post observed, based on Louisiana Representative William Jefferson’s recent 13-year sentence for accepting a $100,000 bribe, Landrieu should spend the next 39,000 years in jail.

(3)    Pelosi violated her pledge to post the final version of any legislation online for 72 hours.  Instead, she and Reid have been finishing their handiwork on Friday night and ramming through their votes on Saturday night.  Defeating these bills would be hard enough if the public had time to digest them and hold politicians accountable for supporting them, but now congressmen can claim that they were unaware of ornery provisions slipped in at the last minute, because they were unable to speed-read 300 pages of legalese an hour.

(4)    Leaders of both houses have been inserting, modifying, watering down, or removing passages to get approval for the bill or beginning debate, when they know full well that crucial blocs of defectors will never vote for current legislation in the final vote.  These holdouts will demand that all changes be unmade, which will cause even larger chunks of the Democrats’ fragile majorities to drift away.  For example, Pelosi banned federal funding of abortion in the House bill, a restriction that a dozen representatives will never accept in the final bill.  Reid reinserted in the Senate bill a public option, which had been absent from all committee versions, when he knows that every Republican and at least four Democrats would filibuster a vote on such a bill.

(5)    Reid bought holdout votes from centrist Democrats by making minor concessions tailored to their districts’ concerns.  To support the final bill, these and other Democrats are demanding much bigger concessions, which conflict with each other and with demands made by those in the House.  It is not physically possible to satisfy all of these lawmakers’ requirements at once, which is why Reid and Pelosi have barely been able to do it with 12 different versions of the bill over a period of several months.

(6)    Democrats are willing to slash funding for Medicare, which Jay Cost calls “the most significant fiscal policy ‘achievement’ of the Democratic Party in the last seventy years” [scare quotes mine].  Doing so has cost them the support of seniors, who oppose the bill even more comprehensively than the general public.

(7)    Rasmussen reported on Monday that support for the bill has fallen to a new low of 38%.  Some Senators have been jeopardizing their reelection in 2010 by their support for their bill, and at least one—junior Senator Michael Bennet—has been bragging about it.

(8)    Senator Chuck Schumer is now resorting to bald-faced threats, which should go over wonderfully with the public; recently he declared on behalf of all of Congress, “We’re not going to not pass a bill.”

All of this is already starting to take its toll on Democrats: witness the retreat of Republican Senator Olympia Snowe, who voted not to allow debate on Reid’s bill to proceed, when formerly she had been trumpeted as giving the bill a bipartisan veneer by supporting the Senate Finance Committee’s version.  Democrats think they can pass a bill by tossing concessions left and right to keep the ball rolling through each stage, but their momentum is eventually going to grind to a halt.

On a more general note, anyone trying to do something impossible—in this case, have government take over a sixth of the economy and provide better, more widespread care at lower costs than the private sector, with no sacrifices required from anyone—necessarily fights a harder battle than his opponents, because reality is not on his side.  Republicans, as ineffective and mealy-mouthed as some of them have been in making the case against Congress’s bill, possess the inherent advantage of the truth.  The American people and a vigilant alternative media can discover the truth if no one else will.

Congressional Democrats up for reelection next year for one of 535 seats are about to experience a whole new type of rationing.

Democratic proponents of health care reform have the following major goals:

(1)    Create a federal public health insurance option to “compete with” private insurers, or

(2)    Set up state cooperatives to “compete with” private insurers on a state-by-state basis;

(3)    Prevent discrimination by insurance companies based on preexisting condition—i.e., forbid insurance companies from “providing insurance”;

(4)    Limit the ratio of high-to-low insurance premiums by age group.

Whether pursuing any of these goals is the government’s business—and it isn’t—Democrats need to enact some combination of these proposals in order to fulfill their aim of turning us into Canada; the Congressional Budget Office estimates that this will cost about $1 trillion.

Democrats have proposed numerous bad ideas for paying for their legislation, all of which lead to intractable circumstances that they cannot tolerate politically with the general electorate, even if they were able to figure out a way to cobble together, rush through, or force the votes in Congress to pass them.  These funding ideas include:

(1)    Increase the deficit: This would violate Obama’s promise that health care reform will be “dime”-neutral.

(2)    Make taxpayers subsidize the public option: This would keep the government plan from having to cut costs or be efficient to attract and retain customers, as any private insurance company must.  It would therefore eventually force those who are satisfied with their current plans to pay higher premiums or get less for their money.

(3)    Cut $500 billion in Medicare: This would upset seniors, and anyone who plans to be a senior at some point in his life, who fear rationing of care.

(4)    Tax high-cost plans at a 40% rate: This would anger emergency workers and union members, and huge numbers of people who will hit the non-insurance-adjusted premium threshold for this level of taxation in the next 10 years.

(5)    Impose fees on insurance and pharmaceutical companies: These costs would simply be passed on to doctors, who would in turn dump them on to patients.

(6)    Cap deductions for health savings accounts: This would increase out-of-pocket medical expenses.

(7)    Force everyone to buy government-approved health insurance by charging a penalty for not having coverage: If the penalty were low, in order to avoid making it burdensome, then people would wait to get coverage until they became sick, then drop coverage after they recovered, which means the penalty would be useless.  If the penalty were high, in order to make it effective, then the public would be infuriated over the imposition of a costly penalty for not buying something that should be optional.

(8)    Cover fewer uninsured people: This would involve turning the nation’s health care system upside down while failing to fulfill the basic aim of the plan.

In case Democrats are interested, there are provisions to which they could agree, all previously proposed in legislation by House Republicans, which would actually pay for the proposed plan.  These steps should be taken anyway, and should be pursued instead of the Democrats’ aims, but just for the record, they include:

(1)    Medical liability tort reform: This would reduce settlement amounts and lower doctors’ malpractice insurance premiums.

(2)    Tax deductions for health insurance premiums, medical expenses, and prescriptions: This would allow people to decide how to allocate their earnings toward medical expenses, which they can do more efficiently than Kathleen “Jolly Roger” Sebelius.

(3)    Vouchers for opting out of Medicare: This would allow people to decide how to spend their money on medical care in old age.

(4)    Interstate provision of private insurance: This would allow for greater competition and cost-cutting.

Despite conservatives’ nail-biting uncertainty over their ability to defeat HR 3200, they have one advantage: the truth.  All the arguments conservatives have advanced against liberals’ bad ideas are informed by it, whereas liberals must disguise it, distort it, downplay it, or lie about it to persuade anyone that their impossible legislative feat and fevered social engineering fantasy can be achieved.  There are plenty of voters and legislators who are content to ignore the truth and stumble down dead ends, but enough may turn out to be smart and honest enough to see through these efforts and find their way out of the labyrinth.

Many of these lonely bills deal with just one or several aspects of health care reform, rather than offering grand, sweeping Ten-Year Plans that will change Health Care As We Know It.  Not all the bills are knockouts; a couple are downright stinkers.  But virtually all contain some good ideas, and some of them contain nothing but good ideas—which means that no Democrat will ever for a moment consider any of them.

For those desiring ammunition to counterattack the liberal slander that conservatives criticize everything on health care they hear from Democrats but have no ideas of their own, here’s a primer on the legislation prepared by our devoted GOP servants in the House:

•    Several bills are flat-out winners, including Clifford Stearns’ Health Care Tax Deduction Act, Michele Bachmann’s Health Care Freedom of Choice Act, and Rodney Alexander’s Sunset of Life Protection Act.  These laws provide for income tax deductions of health insurance premiums and prescription drugs; medical expenses; and long-term care premiums, respectively.  That’s it.  All three bills are so short they could fit on a cocktail napkin together and still have room for a list of Obama’s failed Cabinet nominations.  This is not surprising: bills covering what individuals are allowed to do for themselves require less verbiage than bills mandating what individuals are required to do for their government.

•    Marsha Blackburn’s Health Care Choices for Seniors Act and Louis Gohmert’s Patient-Controlled Healthcare Protection Act allow seniors to opt out of Medicare and receive vouchers for health savings accounts, an arrangement analogous to school vouchers (another excellent idea liberals oppose).  Edward Royce’s Flexible Health Savings Act allows individuals to carry over unused health savings account funds from year to year.

•    John Shadegg’s Health Care Choice Act eliminates restrictions on interstate governing of health insurance, the primary cause of the limited within-state competition among private insurance companies that President Obama keeps bleating about.

•    Two bills—John Gingrey’s HEALTH Act and Michael Burgess’ Medical Justice Act—enact malpractice tort reform by regulating lawsuits for health care injuries or deaths.  William Thornberry’s Medical Liability Procedural Reform Act sets up state “health care tribunals” or medical courts to adjudicate claims.

•    Several unobjectionable but minor bills extend benefits for veterans, reserve members, and their dependents.

•    A few bills would amend the State Children’s Health Insurance Program to supposedly make it more accountable; however, these bills give the costly, bloated SCHIP so much legitimacy that I’m automatically suspicious of their authors’ credibility.

•    Other bills have good intentions but will lead to more bureaucracy and regulation than they aim to prevent; for example, Thornberry’s Health Care Paperwork Reduction and Fraud Prevention Act, which proposes a “Commission on Health Care Billing Codes and Forms Simplification” to standardize billing paperwork.  No doubt the government will first need to establish a separate commission just to simplify the Commission’s name.

•    Thornberry has proposed two more bad bills (why do public officials who want to meddle in our affairs always invent so many devious ways to do it?).  One is the Partnership to Improve Seniors’ Access to Medicare Act, which subsidizes student loan repayment for doctors who accept Medicare patients; not specified in the bill is how much of our bountiful federal surplus we’ll have to dip into to cover this provision.  Another is the Patient Fairness and Indigent Care Promotion Act, which allows doctors to deduct for tax purposes any unrecouped costs from “patient bad debt”—because nothing increases accountability like providing incentives for doctors not to check beforehand whether patients can pay their bills!

Other GOP bills contain additional provisions, and many of the bills are a mixed bag; but the point is that they’re all better than HR 3200, which is putrid right down to its last period.  Considering even a few key GOP bills over the next couple of years would be a sound way to address individual components of health care reform, in a piecemeal fashion, rather than upending our economy right this minute just because Democrats insist on artificial deadlines to maximize their political gain.

In the meantime, the proper response to any liberal who claims conservatives have no ideas of their own on health care reform should be a resounding, “You lie!”

Obama spent most of July insisting that Congress had to pass a bill for him to sign before the August recess, in case they didn’t have enough political momentum by the time they got back.  Privately, Congressional Democrats fumed that Obama was offering no details on his preferred plan and was simply telling his spokespeople to assure them he would not rule out anything they decided.

Just before the recess, Obama got on TV for a Wednesday night address to the nation to “explain” the “details” of his “plan.”  The public’s reaction to his vague answers to reporters’ questions revealed as much frustration at his lack of specifics as Congress felt.

Since then, Obama has played “good cop, bad cop” with an unwilling Congress: Obama makes flowery promises—everyone who’s happy with the status quo can keep things as they are, everyone who’s unhappy can have everything completely different—while Congress is forced to work out the ugly details, like who’s going to pay for the plan.

At some point, Obama shifted away from his push for “health care reform” and began hinting that what he really wanted was “health insurance reform,” but he was too cowardly or indecisive to state his altered intention outright.

Obama similarly began to disavow the necessity of the public option when it became clear there were not enough votes in the Senate to pass a bill with one.  Rather than declare his switch in tactics openly, Obama implied that this had been his position all along, when he had clearly and repeatedly stated in the past that a public option would be necessary in order for him to sign a bill.  After the resulting backlash by House Democrats and Congressional leaders, Obama is once again on the fence about whether legislation must contain a public option or not.

Even New York Times columnists have been grumbling about Obama’s failure to make the case for health care reform.

As Bob Herbert complained, Obama “has been remarkably opaque about his intentions regarding health care.  He left it up to Congress to draft a plan and he has not gotten behind any specific legislation.  He has seemed to waffle on the public option and has not been at all clear about how the reform that is coming will rein in runaway costs.  At times it has seemed as though any old ‘reform’ would be all right with him.”

It’s obvious why dishonest politicians would choose to keep details of unpopular and impractical legislation vague in the early stages—i.e., to keep people from figuring out that it won’t work, will cost too much money, or will give the government greater control over our lives.  But at some point, leaders have to take a stand on what they will and will not tolerate, and let the chips fall where they may.  At  this point, Obama is acting as though he would be content to sign a phone book as long as the cover said “Health Care Reform Bill.”

Obama seems to think he can stay above the fray and maintain his popularity by not get involved in any messy details requiring those things we call “choices.”

But as Michael Barone notes, “The president must either insist on a ‘government option’ insurance plan or must let it be known that he will sign a bill without one…  Sooner or later the old politician’s dodge… won’t wash.”

Obama’s return-from-August-recess televised address to the nation Wednesday night is supposed to make it clear where he stands on the details of the various plans offered by Congress, after several months of hands-off cheerleading on his part.  But it’s obvious that things will be no clearer after his speech than before: his handlers are already scolding curious reporters for wanting to know specifics about what he’ll say and even whether the public will know where Obama stands on the public option after his address.

In a pre-speech interview today, Obama declared that “we do intend to get something done this year,” but hedged by saying that he was still “open to new ideas.”  Open to new ideas?  This is the same guy who demanded that Congress simply had to pass a comprehensive overhaul by the end of July?

Obama and his staffers are urgently motivated to do something, anything, on health care reform, so that they will be able to say that they did—something, anything.

Their plan, known as “budget reconciliation,” works as follows: (1) have Senate committees expand Medicaid, cut Medicare, force individuals to buy and businesses to offer insurance, give subsidies to low-income people and tax credits to small businesses, levy new taxes, and do everything else Democrats wanted to do in their health care bill but knew would never pass; (2) lump it all into a bill; and (3) pass it with 50 votes and no filibuster.

The bill would also contain language to support enactment of a health care overhaul, but because provisions unrelated to the budget cannot legally be included, the Senate parliamentarian will likely strike these from the bill.  According to the New York Times, which favors the reconciliation swindle, it is unclear whether two key elements will be allowed in the bill: the requirement that insurance companies accept all candidates and charge the same regardless of condition, and the creation of a government health insurance exchange.

The Times eggs Democrats on to declare that these two provisions, while irrelevant to the budget, “are so intertwined with other reforms that they are [necessary] for other provisions that do affect spending or revenues.”

If that ruse doesn’t work, the Times notes, then the process could “leave the reform package riddled with holes—perhaps providing subsidies to buy insurance on exchanges that do not exist, for example.”  In this eventuality, Democrats would pass a second bill, subject to filibuster, that fills in gaps where budget-irrelevant provisions were removed.

Ignore for the moment the fact that Democrats’ chess-playing skills obviously aren’t very good: to wit, why would Republican senators support a bill to prop up the reconciliation bill, if the two bills in combination would lead to an outcome they opposed in the first place?

Ignore, too, the stipulation that the reconciliation bill may not legally cause deficits to increase, which a health care overhaul clearly would do.

There’s just the inconvenient detail that reconciliation was never designed to be used for anything remotely like what Democrats propose to use it for.

According to the U.S. House of Representatives’ Committee on Rules, the purpose of budget reconciliation is to “fine tune revenue and spending levels.”  Admittedly, in the Obama era, adding a trillion-dollar program here or there could be characterized as “fine tuning,” but I don’t think this is what the creators of reconciliation had in mind.

Democrats have offered the following compelling argument for using reconciliation to socialize health care: Republicans have used reconciliation!

Yes, Republicans have used reconciliation—for things it was supposed to be used for, such as adjusting tax rates and decreasing entitlement spending.  Claiming that reconciliation can be used for health care because Republicans have used it is like claiming that pesos can be used at Taco Bell because Mexicans have used them.

Even the New York Times admits, “The approach is risky.  Reconciliation bills are primarily intended to deal with budget items that affect the deficit, not with substantive legislation like health care reform.”  Note the sneaky, dishonest addition of “primarily.”

As Judd Gregg explained to Norah O’Donnell, who insisted Gregg was a hypocrite because he had favored reconciliation in the past, “Reconciliation is meant to adjust already existing programs.  You adjust tax rates, or you adjust already existing programs at the margin.  What’s being proposed here is, ab initio, a brand-new, major initiative which is the total rewrite of the health care system of the United States.”

President Clinton floated the idea of using reconciliation to pass health care legislation in 1993, but Senator Robert Byrd reminded him that reconciliation was meant to be used to square away budgets, not turn us into Canada.  In 2003, Congressional Republican leaders considered, then rejected, using reconciliation to pass their prescription benefits program.

In 2005, Senate Republicans introduced a provision allowing drilling for oil in the Arctic National Wildlife Refuge, an attempt that failed when the provision was removed during reconciliation.  Whether this attempt was appropriate or not, it should be pretty clear that if we’re not allowed to use reconciliation to drill in a barren wilderness that makes up less than 0.5% of Alaska in the middle of an energy crisis and a war in Iraq, then it’s not appropriate to use budget reconciliation to take over 17% of the economy.

There’s a reason budget reconciliation was introduced as a separate parliamentary process: it was to be used to make adjustments to existing programs, not introduce massive new ones.  The total amount of debate time allowed for reconciliation is only 20 hours—about twice as long as Congress had to read the 1,600-page stimulus bill before voting, but still not very long.

By the way, I don’t fault Obama for threatening to violate the spirit of bipartisanship with the reconciliation maneuver, inasmuch as (1) I don’t favor Republicans in charge having to compromise when Democrats propose screwy ideas and (2) in order to put a halt to bipartisanship, Obama would have had to actually start practicing it first.  But it’s ironic that Congressional Democrats believe they are putting aside their longstanding, magnanimous display of bipartisanship by resorting to sleazy use of a tactic called “reconciliation.”