The Republican failure to repeal Obamacare after seven years of promises to do so can be generally blamed on incompetence and political cowardice, from Donald Trump on down and, more specifically, on the grandstanding and desire for revenge of one particular Republican, John McCain.
But the broader logic of welfare-state liberalism also made repeal and any kind of substantive replacement something of a long shot all along.
Yes, McCain, as is his wont, played to the galleries, defined as his liberal admirers at the Washington Post and New York Times and across the Senate aisle among Democrats. He thus intensifies his late-career push for the "Democrat's Favorite Republican" title previously held by the likes of Lowell Weicker, Arlen Specter, and Jim Jeffords.
When you sucker-punch your own party at the midnight hour and reap praise from the likes of Chuck Schumer and Harry Reid, something is wrong with the picture.
That McCain is a self-interested party of one was also reaffirmed in a recent Politico piece by Philip Shenon on how the Arizona senator, bitter from his loss of the GOP nomination to George W. Bush, came awfully close back in 2001 to switching to the Democratic Party and thereby handing it control of the Senate. Plans were being made for a press conference to make the big announcement when McCain was beaten to the punch by Jeffords' desertion; his grandstanding play having been pre-empted, he ended up staying with the party whose presidential nomination he had just sought (and would later win), purely out of convenience.
At this point, it will be interesting to see if McCain, having almost left the Republican Party in 2001 out of pique and a desire for revenge on Bush and the party establishment, considers it again; whether, perhaps with the other Republican pariahs who voted against repeal, Alaska Sen. Lisa Murkowski and Maine Sen. Susan Collins, they sell themselves and control of the Senate to Schumer and company.
McCain, acting out of his usual petty motives, clearly wanted revenge upon Trump for his slighting of his war record, and it remains to be seen how much further his vendetta will go.
But political outcomes are ultimately about more than simply the grudges and resentments of vain politicians, and any effort to explain why Obamacare is still with us must also reckon with one of the few iron laws of democratic politics in the welfare-state age--that welfare-state entitlements, given time to become entrenched, can never be repealed, however costly and counterproductive their consequences.
Any hope that Obamacare could become an exception to that law began to fade five years ago when it was saved by John Roberts' Sebelius ruling, wherein he surprisingly and expediently "reinterpreted" the individual mandate as a tax rather than a fine, and when, just a few months later, its namesake only slightly less surprisingly won a second term as president.
With each passing week thereafter, the odds of any genuine repeal and replacement of Obamacare receded. Republicans in Congress could pass all kinds of measures toward that end, but purely for symbolic effect and knowing full well that Obama would veto them. They could, in other words, reap the benefits of running against Obamacare without having to run any of the risks associated with repealing it.
Bastiat's law of "seen benefits, unseen costs" still holds true--by concentrating benefits and dispersing costs, welfare-state entitlements quickly create invested electoral constituencies that care much more about preserving their benefits than those paying for them care about getting rid of them, and politicians will always cater to the effectively mobilized former over the larger but effectively disorganized latter.
In the end, we must also recognize that the true force of "creative destruction" in advanced democratic societies is not, as Joseph Schumpeter once observed, free-market capitalism but welfare-state liberalism, largely because it inexorably advances despite and actually because of its failures.
No honest person, perhaps not even any of those Democrats in the Senate who voted as a bloc to save it, could argue that Obamacare has been a success in terms of improving American health care and lowering health-care costs. And no honest person could deny that it is also inexorably headed toward collapse due to its myriad defects, probably sooner than later, barring any expensive legislative fixes to prop it up. It has, in short, gone a long way toward finishing off what was an already wobbly American health-care system.
But therein also lies its beauty politically, if not economically: By devastating American health care, Obamacare has provoked, as was intended, a demand for more government intervention therein; more precisely, calls for the kind of single-payer, government-run system that the left has long (mostly covertly) dreamed of.
Obamacare didn't actually "fail"--it is working as designed by producing the kind of mess that will ultimately move us still further toward a socialized health-care system. As usual, the distress caused by progressive programs creates a demand for more progressive programs to alleviate the distress.
Even when it loses, progressivism wins. Its victories, like Obamacare, are not only irreversible, but their dismal consequences pave the way for more.
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Freelance columnist Bradley R. Gitz, who lives and teaches in Batesville, received his Ph.D. in political science from the University of Illinois.
Editorial on 08/07/2017