Train wreck

PelosiCare makes it through

Date published: 11/10/2009

BY A SHOESTRING margin, House Speaker Nancy Pelosi managed to squeeze out enough votes over the weekend to pass a health care reform bill. Now she's tossed the hot potato to the Senate, where a cooler reception awaits.

In a 14-hour Saturday marathon marked by a presidential visit, impassioned speeches, and a wrenching compromise, the House passed the 1990-page leviathan 220-215, just two votes over what Mrs. Pelosi needed. All the Republicans but one (Rep. Ahn Cao of Louisiana) and 39 Democrats voted against the bill. The ink had barely dried when President Obama began pressuring the Senate to "take up the baton and bring this effort to the finish line."

The House bill, which would cost $1.2 trillion over a decade, mandates that every American carry health insurance, provides subsidies to help pay for it, and creates an insurance exchange where people can buy it. The bill would establish 111 new bureaucracies and would pay for its provisions with a new income tax on millionaires, hundreds of billions in Medicare cuts, and a gutted Medicare Advantage program.

Without a hotly debated compromise, Mrs. Pelosi's efforts would have failed: By agreeing to strong language banning coverage for abortion, she lured some pro-life Democrats into the "aye" column. Many Blue Dog Democrats (fiscal conservatives) held the line, still appalled by costs. As well they should be: The Congressional Budget Office's estimate of $1.2 trillion does not include "administrative costs" and other associated items.

History repeats: In 1966, the Office of Management and Budget estimated that Medicare would cost $66 million. It actually racked up a tab of $770 million that year; in 2011, the annual tally will be $500 billion. With unfunded liabilities on a course to reach a stratospheric $37 trillion over 75 years, Medicare provides a window into our bankrupt future.

The Pelosi bill is being called "dead on arrival" in the Senate, where Democrats have failed to basket the votes to swing its "public option" provision. There, the fiscally responsible--let's hope this describes Virginia's two Democratic senators--can yet slow this runaway train.

Sen. Mark Warner, a savvy businessman who styles himself a "radical centrist," and Sen. Jim Webb, a clear-thinking moderate, could either one reach for the brake handle. This train needs a new destination: Reform health care without destroying the future.

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Date published: 11/10/2009

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