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Shutting Down the Government Over Health Care
Much of the media, and certainly the Democrats, have been unfair to congressional Republicans in characterizing their decision to shut down the government as "outrageous," "crazy" or even "terrorism." It is undoubtedly an extraordinary measure, but sometimes extraordinary measures are warranted.
Suppose it were 1968, when the United States had more than 500,000 soldiers in Vietnam and was bombing the country on a daily basis, killing thousands of people every week. How many people would view it as outrageous if Congress had voted to shut down the government until President Lyndon B. Johnson agreed to end the war? In fact, most people might view the inconveniences associated with a shutdown — and the real pain endured by government workers — as justified if it could bring an end to the killings in Vietnam.
The difference between shutting down the government to end an unjust war (or to advance any of the other great causes of recent decades) and what the Republicans are doing now is that the Republicans do not have a great cause. They are trying to keep people from getting health care. This is the disaster the Republicans hope to prevent by shutting down the government.
There are many grounds for complaining about aspects of the Affordable Care Act (ACA), also known as Obamacare. There is no public option, so people have no choice but to get care through private insurers. The cost controls are limited, which means that doctors, drug companies and medical-supply companies will likely continue to overcharge patients.
But these are not the issues that trouble the Republicans. The lack of adequate cost controls and other problems like it are items that can be fixed once the program is in place. These problems would hardly justify a government shutdown.
The reason the Republicans are prepared to go to the wall to stop Obamacare is simple: They are terrified that people will get it and like it. This would destroy the central political message of their party for the last four years. While Republicans have attacked just about everything President Barack Obama has or has not done during his presidency, there is nothing that has aroused more vitriol than the ACA.
As long as Obamacare was just a law on paper, and not a program that actually provided people with health insurance, the GOP could fabricate all sorts of horror stories. It could tell people that government bureaucrats would be in the doctors' offices with them, that they would never be able to get a doctor — it could even tell them that death panels would kill their parents and grandparents.
Most people do not have the time to pore over laws that are several thousand pages, so they have no direct knowledge of what is in the ACA. And the media's view of objectivity means they pass along Republican assertions about Obamacare without comment, regardless of how absurd those assertions may be. As a result, tens of millions of people hold many false beliefs about Obamacare. According to the September Kaiser Health Tracking Poll, as recently as last month only one in eight of the uninsured realized they would be able to start signing up for insurance on the exchanges at the start of October. This poll found that public awareness of many of the law's key provisions had not increased since 2010, and some stubborn misperceptions persist.
Until now, Republicans could get away with screaming about the horrors of Obamacare. But once people start getting health care through the program, or see their family and friends getting health care through the program, they will know what the ACA actually is.
At that point, the Republicans might just as well be screaming about the evils of Medicare. When people understand that Obamacare is first and foremost about getting health insurance, they are going to like it. They will have many grounds for complaint, just as they do with Medicare, but even the vast majority of Republicans will not want to go back to the pre-Obamacare world.
Understanding, then, what is at stake for the Republicans, it is easy to see why they would be willing to shut down the government or even default on the government's debt. The mission that has been at the very center of their agenda for the last four years is about to be shown as completely wrongheaded. Not only would Democrats be able to point fingers at the GOP, but its own followers will realize they have been misled.
At this point, Republican leaders presumably recognize that they have backed themselves into a nearly impossible position. But they are still hoping they can somehow grab a concession that will lead to the unraveling of Obamacare before it begins to take hold.
If they can delay the individual mandate for a year, perhaps they can delay it again next year. Then they may be able to persuade the insurance companies to commit themselves to a major push toward ending the program. Similarly, they hope that ending the medical device tax (which offsets extra profit given to these companies through the ACA) can lead to a revenue shortfall that will reduce subsidies and make it more difficult for many to afford insurance.
But these tactics are desperation moves. The public is about to find out that the central theme of the Republican political agenda for the last four years is a lie. And that is not a pretty story.