Scott Spiegel

Each of the two ratified versions of the health care bill currently waiting in Congress was barely passed, by virtually the slimmest margin possible, in a hectic last-minute stampede.  Dozens of harsh compromises had to be hammered out to cobble together the fragile framework now standing in each chamber.

The two bills are like delicate Jenga towers, swaying nerve-wrackingly in the breeze, that must now be reassembled by a team of 535 clumsy attention-seekers into a tower twice as tall.  But legislators across the two chambers—and even within them—are not even speaking the same language.

Here are a few of the myriad discrepancies legislators must reconcile to ensure that their monument to Obama’s greatness doesn’t fall:

In the House version of the bill, a government-run insurance exchange is created on a national level and includes a public option.  In the Senate version, exchanges are created on the state level and do not include a public option.  Virtually identical!

The House completely bans the practice 0f charging those with preexisting conditions higher premiums.  The Senate allows insurers to offer unlimited discounts for customers who engage in subjectively defined wellness activities: say, exercising, eating healthy, “not having contracted lung cancer”…

Insurance exchanges are implemented in 2013 in the House bill and 2014 in the Senate bill.

In the House version, employers are forced to provide insurance for their employees and pay a fine if they do not.  In the Senate version, employers are not required to provide insurance, but pay a fine for employees who opt for government-run insurance and receive federal subsidies.  The House has higher penalties than the Senate.

The House version funds the bill by imposing a surtax on families making over $1 million a year.  The Senate version establishes a tax on those with “Cadillac” plans, which includes not only many union members, but millions of families who will unexpectedly find themselves unlucky Cadillac owners over the next 10 years due to the non-inflation-adjusted nature of the provision.

The House version does not tax insurance offered by employers; the Senate version taxes employer insurance above a threshold.

The House version charges older people a maximum of twice the premiums as younger people; the Senate version sets a maximum ratio of three-to-one.  The House offers fewer insurance subsidies for the middle class than does the Senate.  The Senate offers weaker measures to limit out-of-pocket costs than does the House.

The House bill covers 5 million more people than the Senate bill by expanding Medicaid to those earning up to about $2,000 more than in the Senate bill.

The Senate version gives $100 million to Nebraska for indefinite coverage of all new Medicaid enrollees in the state (to buy Ben Nelson’s vote).  The Senate bill gives $300 million to Louisiana for Medicare increases (for Mary Landrieu’s vote); $10 billion to Vermont for new public health centers (for Bernie Sanders’ vote); billions to Nebraska and Michigan to waive nonprofit insurers’ excise taxes (for Ben Nelson and Carl Levin’s votes); millions to Massachusetts and Vermont for Medicaid; and millions to Florida, New York, and Pennsylvania for Medicare Advantage.  None of these provisions is in the House bill.

The Senate version includes, per the insistence of construction unions, an important exception to the employer mandate.  As an article in the New York Times titled “In Health Bill for Everyone, Provisions for a Few” reports, “Under the Senate bill, businesses with fewer than 50 employees would be exempt from the penalties in every industry but construction.”  In the construction industry, the mandate holds for employers with as few as 5 employees.  The House includes no such provision.

Restrictions on abortion funding are tight in the House, with no federal funding allowed; and loose in the Senate, with mere separation of federal and private money, and states allowed to make up whatever rules they want regarding abortion funding.

Coverage for illegal immigrants is not disallowed in the House; it is explicitly banned in the Senate.

It should be sobering for Democrats to realize that if just one Senator or two Representatives decide they can’t tolerate the alternative version of even one of these provisions, that will be enough to topple the whole health care reform edifice.

It’s no wonder, then, that Congressional Democrats now plan to merge the bills behind closed doors, shutting out all Republicans from discussion of the reconciliation process and preventing them from using parliamentary procedures to slow consideration of the bill and allow the public to digest the proposed changes.  Talking Points Memo cites one Democratic House aide who proudly admits, “This process cuts out the Republicans.”  The House will simply take the Senate’s bill, amend it, vote on it, and send it to the Senate; who will then amend the bill, vote on it, and send it to the House; and back and forth until some hideous, lopsided, structurally unsound blueprint garners enough votes in both chambers.

If Democrats had to merge these two bills in a public conference committee—never mind on C-SPAN, as previously promised and recently offered by the network’s CEO—it would take about five minutes for the cacophonous clatter surrounding their health care Tower of Babel to bring it crashing down.

The problem with modern-day liberals’ penchant for implementing proposals not authorized by the Constitution isn’t just that they’re sticking their noses where they shouldn’t; it’s that they aren’t sticking their noses where they should.

Fresh out of the gate, in the early days of his administration, President Obama decided to continue President Bush’s plan to take over the nation’s largest car companies and banks by tempting them with bailout funds, then tightening the noose around their necks and micromanaging them from Washington.  Soon after, Obama decided to force taxpayers to guarantee virtually all U.S. mortgages, thus sticking a $5 trillion tab to people who had largely paid their mortgage bills on time.  Recently, Obama decided to cap executive pay for banks that took bailout money, and has expressed an interest in monitoring executive pay for even banks that didn’t take TARP money.

Congress is currently considering unconstitutional legislation—stalled only because they are trying to pass even bigger, more expensive unconstitutional legislation—to impose cap-and-trade regulations to restrict and tax individual citizens’ energy use.

This summer, Obama carried out an amusing little $3 billion scheme that involved paying car owners to destroy their used automobiles and buy new ones, a jaunt that resulted in no significant net energy conservation in the U.S., boosted the auto industries of Japan and South Korea, and hurt the American used car business.

Since July, Democrats’ pet project has been to take over the U.S. health care system.  Not crazy enough to try to force through a single payer system, Senate Leader Harry Reid nonetheless went “rogue” on Monday, in defiance of Senate committee members and moderate Democrats, and announced that the Senate version of the health care reform bill would offer a public health insurance option, though such an option has zero chance of passing in the Senate.

Other fun and unconstitutional dalliances the administration has undertaken in recent months include:

•    Nationalizing the student loan system

•    Nominating for the Supreme Court a justice who believes in ignoring the equal protection offered under the law and considering race and gender in her rulings

•    Threatening to violate free speech rights by regulating the Internet and talk radio in order to ensure “balanced” views and prevent “irresponsible” content

•    Attacking a private organization, FOX News, for criticizing the administration, and threatening its right to freedom of the press by shutting it out of White House interviews to which other major news organizations are invited

•    Appointing 34 unaccountable czars—“green jobs czar,” “science czar,” “diversity czar,” “czar witness protection program czar”—to set policy while circumventing Congress’s approval of either policy or czars

•    Engaging in massive, unprecedented deficit spending to stimulate the economy

Obama’s expansion of federal government rivals the explosion of federal agencies resulting from FDR’s New Deal and the establishment of the Department of Health, Education, and Welfare in the 1950s.

If the Obama administration finds a free moment from poking around in the Constitution identifying such lame justifications for its schemes as “promoting the general welfare,” it might consider dealing with the following urgent tasks, which are actually allowed by the Constitution but seem to have fallen by the wayside:

•    Providing adequate troop levels for our ongoing war in Afghanistan, as the General whom Obama hired to turn around the war requested several months ago.  Joseph Curl of The Washington Times notes, “The White House bristles when asked whether Mr. Obama is so distracted by domestic affairs and health care that he is unable to focus on Afghanistan.”  Hint to Obama: People don’t “bristle” about something that isn’t true—they brush it off their shoulders and move on, because they and everyone else know it isn’t true.  Instead of bristling, Obama might want to consider that his interlocutors are on to something.

•    Taking steps to protect the U.S. and its allies from the threat of a nuclear Iran—beyond Obama’s chilling warning to Iranian President Mahmoud Ahmadinejad that he will meet him “without preconditions or preconceptions.”  As the UK Telegraph recently reported, Israel’s former deputy defense minister has somberly observed that Israel can no longer rely on the U.S. to rein in Iran’s nuclear program if Israel wants to survive as a nation.

•    Sticking up for allies Poland and the Czech Republic and honoring our agreement to defend them against potential Russian aggression

•    Providing adequate funding for missile defense rather than slashing it to make room for bloated domestic spending

•    Standing up for human rights in Iran—by not waiting a week after anti-government protests to support the protestors; in China—by not having our Secretary of State rhetorically place the issue of human rights below that of reversing climate change; and in Tibet—by not refusing to meet the Dalai Lama in order to appease China

•    Defending the Honduran government’s enforcement of its constitution in their ouster of President Zelaya for attempting to violate presidential term limits

Recently, The New York Times’ Bob Herbert came out against fighting crime in New York; he called it a racist promise for Mayor Bloomberg to make in his reelection bid.  The Times’ editorial board no doubt approves of Obama’s Attorney General Eric Holder’s early decision to drop charges in the Black Panther voter intimidation lawsuit brought last fall after a harassment incident in Philadelphia on Election Day.

If protecting citizens against violent crimes by fellow citizens isn’t a legitimate Constitutional function, then what is?

I think we have a good idea regarding the priorities the administration will and will not be focused on for the next four years.

President Obama is the opposite of Hamlet—he is desperately eager to do something on health care reform, right this minute, but he doesn’t particularly have any idea what it should be.

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.

The pile of victims President Obama has thrown under the bus in his attempts to get health care reform passed is growing so large that just treating their internal injuries is going to bankrupt the national health care system.

First it was the insurance companies.  When Obama realized early on that Americans weren’t chomping at the bit for socialized medicine, he subtly changed his language to imply that he was merely seeking “health insurance reform.”  Insurance companies, to remind Obama, by definition have a vested interest in not covering costly treatments for people with a 100% risk of having a particular medical condition.  But the administration nobly promised to go after, as the New York Times put it, “unpopular insurance industry practices, like refusing patients with pre-existing conditions”—also known as “providing insurance.”

Nancy Pelosi swore to oppose the “shock and awe, carpet-bombing by the health insurance industry to perpetuate the status quo”—as opposed to the couple, two-three homemade signs proffered by paid armies for Health Care for America Now, Organizing for America, SEIU, and ACORN.  Obama promised to “reform the insurance companies so they can’t take advantage of you.”  Pelosi slandered insurance companies as “villains.”

Surprisingly, insurance executives didn’t take kindly to being called monsters.  Karen Ignagni, CEO of America’s Health Insurance Plans, seethed, “Attacking our community will not help get anyone covered…  We have to… correct the record.”

Next it was the pharmaceutical industry: in June, Obama twisted drug companies’ arms into forking over $80 billion toward health care reform, on the condition that the government would not bargain for reduced drug prices for Medicare or mandate price rebates.  Industry lobbyists, just to make sure they weren’t going to be stabbed in the back like the insurance companies, wrote the White House and secured confirmation from White House officials that these promises would be kept.

Congressional Democrats heard about these communications and had a fit.  The administration subsequently claimed that no such conditions had ever been discussed.  One of the House versions of the bill emerged containing provisions mandating both government drug price negotiations and additional price rebates.

Obama then started sacrificing groups less directly involved in health care but assumed to be shoo-in supporters of his agenda.  First he falsely claimed that AARP had endorsed Congress’s health care legislation: “We have the AARP on board” and “AARP would not be endorsing a bill if it was undermining Medicare.”  AARP’s terse response: “Indications that we have endorsed any of the major health care reform bills currently under consideration in Congress are inaccurate.”

Then Obama tossed 760,000 U.S. Post Office employees in the street when he argued that private health insurers wouldn’t be threatened by a public option: “If you think about it, UPS and FedEx are doing just fine.  It’s the post office that’s always having problems.”

The President of the National Association of Postal Supervisors responded to this charming occupational morale booster by sending Obama a letter asking him to rescind his comments: “On behalf of the 35,000 members of our association, I am writing to express our collective disappointment that you chose to use the Postal Service as a scapegoat…  [Y]our negative references to the Postal Services without knowledge of the facts was a disservice… to all postal employees…  [I]t was a kick to the chest to have you take a shot at a group of federal employees who are working hard every day to support this country…  [W]e would like to be treated fairly and not have our current situation misrepresented, especially by the Commander-in-Chief.”

Such Obama tactics recall his disastrous health care forum last month, in which he planted a question about Cambridge Police Department Sergeant James Crowley’s arrest of Henry Louis Gates, Jr., which gave Obama the chance to change the subject and denigrate blue-collar Massachusetts police officers who support him.  As department member Sergeant Kelly King stated after Obama declared that her department had acted “stupidly”: “It’s unfortunate.  I supported the president.  I voted for him.  I will not again.”

Obama even threw his dead grandmother under the bus—again.  When Sarah Palin charged that proposed legislation would lead to death panels that ration health care and decide which old people are not worth saving, Obama said he had favored his grandmother’s hip operation while she was alive, but could understand how a government panel might have calculated otherwise.

Unlike insurance companies, drug companies, the AARP, the post office, and the police, Obama’s grandmother couldn’t respond to his delightful remarks.  Would Obama have dared use that example if she were alive and in need of the operation?  Why doesn’t he try using it on seniors at townhall meetings who are in need of costly treatments?  “I’d pay for your operation if I were your relative, but I can see how a government panel made up of people you don’t know might feel otherwise.”

The latest Obama special interest group to be Greyhounded is House Democrats.  In June, Obama declared, “Any plan I sign must include an insurance exchange… including a public option.”  On Sunday, Obama demurred, “The public option, whether we have it or we don’t have it, is not the entirety of health care reform.”  Health and Human Services Secretary Kathleen Sebelius insisted that a public option, which House Democrats heavily favor, is “not the essential element” of the plan.  Why, whatever gave you that idea?  Was it perhaps inclusion of the ambiguous word “must”?

Predictably, House Democrats have not accepted this about-face without a fight.  According to New York Representative Anthony Weiner, “Some of us who have gotten roughed up pretty good at town hall meetings and stuck in there because we believe in this, now kind of feel like we have a tire track on our chest where the bus that rolled over us is.”

Fortunately, House Democrats are the one party in all of this who deserve to be thrown under the bus—which is probably why the administration is already backtracking on their disavowal of the public option.