Saturday, August 29, 2009

The Kennedy Contradiction

That Edward Kennedy was a true "lion of the Senate" has by now been said by enough pundits and members of the chattering class as to render the phrase the artless and clunky cliche it was no doubt destined to be. Edward Kennedy was a formidable Senator, having put forward more than 2,500 pieces of legislation in his career, over 500 of which were enacted into law. Even a brief sampling of the laws he had a hand in passing shows an extraordinary breadth of legislative accomplishment: the Americans With Disabilities Act, No Child Left Behind, Head Start, Immigration Act of 1965, and the National Cancer Institute (for which he obtained the support of no less an adversary than President Richard Nixon merely by taking his name off the bill) are but the smallest sampling of historic legislation Kennedy helped bring into being.

Edward Kennedy was not just a "lion of the Senate", he was a true "lion of liberalism"--and perhaps the last such lion. Kennedy's vision of government was an extension of the progressive ideals of FDR's New Deal, and Lyndon Johnson's Great Society. To such liberals, "the forces of government should be marshaled to improve conditions for the greatest possible number of Americans, with particular emphasis on the excluded and disadvantaged. It is not government’s only obligation, in this view, but it is the paramount one." It is an expansive view of government, one opposed not only by Republicans, who at least nominally hew to the Reagan aphorism that "Government is not the solution to our problem. Government is the problem." but also by moderate Democrats who fashion their politics after President Clinton's "third way".

That Kennedy firmly believed in the unchallenged virtue of expansive government is beyond question. One need look only to his famous speech at the 1980 Democratic Convention, which laid out a veritable manifesto of liberal political ideas and policies:
Let us pledge that we will never misuse unemployment, high interest rates, and human misery as false weapons against inflation.

Let us pledge that employment will be the first priority of our economic policy.

Let us pledge that there will be security for all those who are now at work, and let us pledge that there will be jobs for all who are out of work; and we will not compromise on the issues of jobs.
Indeed, much of today's rhetoric about health care reform is a mere restatement of what Kennedy said nearly 30 years ago:
Finally, we cannot have a fair prosperity in isolation from a fair society. So I will continue to stand for a national health insurance. We must -- We must not surrender -- We must not surrender to the relentless medical inflation that can bankrupt almost anyone and that may soon break the budgets of government at every level. Let us insist on real controls over what doctors and hospitals can charge, and let us resolve that the state of a family's health shall never depend on the size of a family's wealth.
So it is that one can see in Kennedy's own words the great contradiction that is at the core of Kennedy the Senator, Kennedy the Liberal, and indeed of all the progressive liberal ideology of which Kennedy was the last great champion. That contradiction is a sublime bit of hypocrisy--that to care for people is to shield them from the slings and arrows of outrageous fortune, and thus some people must so order society as to "protect" the rest of humanity. The essence of liberalism is that individuals are powerless even to decide their own fates; Kennedy seemingly extended that pessimism into his personal life, judging by his handwringing over Chappaquiddick:
Kennedy's future loomed, suddenly uncertain. "What am I going to do, what can I do?" Kennedy asked.
By being the last lion of liberalism, Kennedy thus became the living demonstration of liberalism's failure--the philosophical failure of its policies and practical failure of its politics. His education legislation (Head Start, No Child Left Behind) has not reversed declining quality in American education.   Despite the creation of the National Cancer Institute, the prognosis for people afflicted with the brain cancer that claimed Kennedy has improved only a little--and for many other cancers has not improved at all. His reputation as a bipartisan, collegial, and even compassionate legislator did not stand in the way of his highly partisan, inflammatory, and highly inaccurate attacks on Reagan Supreme Court nominee Robert Bork:
"Robert Bork's America is a land in which women would be forced into back-alley abortions, blacks would sit at segregated lunch counters, rogue police could break down citizens' doors in midnight raids, schoolchildren could not be taught about evolution, writers and artists could be censored at the whim of the Government, and the doors of the Federal courts would be shut on the fingers of millions of citizens."
For Kennedy the Liberal Lion, everything, including basic civility and decency, could and should be sacrificed to advance the liberal agenda.  Indeed, with his savage attacks on Bork, Kennedy introduced politics and policy into the judicial confirmation process in a way that has continued ever since, as every subsequent nominee is subjected to grilling on his or her judicial philosophy, with the Senate sitting in judgment on whether that philosophy comports with the American "mainstream." For Kennedy the Liberal Lion, the end of preventing a jurist whose ideas might be at odds with Kennedy's liberalism justified the means of upending the old Constitutional order of Senators ensuring federal judges were technically qualified and competent to interpret federal law and replacing it with a new order of Senators approving judicial appointments on the basis of whose theories of jurisprudence best advanced their agenda.

In the end, even the rule of law gave way to the cause of Kennedy's liberalism. In 2004, when the junior Senator from Massachusetts, John Kerry, was running for President, Kennedy persuaded the Massachusetts legislature to strip the power to appoint a replacement from the Republican governor, Mitt Romney. In 2009, with health care reform legislation hanging in the balance, he wrote to that same legislature asking them to reverse that law, so that Democratic governor Deval Patrick could speedily appoint Kennedy's successor. The end of securing Massachusetts' second Senate seat for the Democrats justified the means of cynically reversing a law passed barely five years ago.

The contradiction that was Senator Edward Kennedy was the contradiction of all liberals who look to government as the agent of social change and social justice--that government must mandate the just order of society because man by himself has failed to do so, and so society must trust those men who serve in government because none other can be trusted.  It is a sad, albeit fitting, epitaph to note that the greatness of his career was predicated on the smallness of his vision of humanity.

Monday, August 24, 2009

An Honest Debate?

In his 22 August 2009 Internet and radio address, the President called for "an honest debate" on health care in this country.  Specifically, he called for one not "dominated by willful misrepresentations and outright distortions, spread by the very folks who would benefit the most by keeping things exactly as they are."  At the same time, he rather facetiously claims that "we've had a vigorous debate about health insurance reform, and rightly so."

To quote one of his erstwhile allies in the Congress, Barney Frank, that last statement invites the question of the President: "On what planet do you spend most of your time?"

What "vigorous debate about health insurance reform" is he talking about?  Is he referring to the reform (the meaning of which is, after all, "to change things") which pledges to allow the 84% of Americans with insurance who actually like what they have to keep things exactly as they are?  Is he referring to the reforming of health care costs, with the goal of "bending the curve down" towards lower costs overall, which commits the federal government to spend an additional $1 Trillion over the next 10 years?  Is he referring to the reform of extending insurance to the much ballyhooed 47 million in this country who do not have insurance--which includes some 10 million illegal immigrants and about double that number of people with incomes well above the poverty line who, for whatever reason, simply choose not to purchase health insurance?  Is he referring to the reform of expanding the use of diagnostic procedures and tests to catch disease early in hopes of reducing costs of care--the cost of which increase overall health care spending?

Of all the "outrageous myths" being spread about health care reform, the most outrageous is that there has been any debate at all on the topic.  Insurance reform that begins with promising 84% of Americans that nothing will change cannot be reform by definition--if nothing is changing, nothing is being reformed.  Cost reform that does not seek to alter the dynamics of health care economics cannot be reform by definition--if nothing is changing, nothing is being reformed.  Reforming treatment protocols by using more tests to identity more sick people to apply existing treatment regimens cannot be reform by definition--if nothing is changing, nothing is being reformed.

A true debate on health care reform would openly question the status quo in American health care.  One such question, which gets only scant attention, either from the Congress or the media, is "why must health insurance be an employment benefit (and thus employer-subsidized)?"  Another such question, which has received equally scant attention from the Congress and the media, is "why are health care providers paid for each test and procedure, regardless of its ultimate utility in treating the patient (the reimbursement scheme generally summarized as "fee for service")?"  A question that is not being asked at all is "how well have existing regulations served in facilitating quality health care delivery?"

I am no doctor, I am no politician, I am no lobbyist.  My interest in health care reform is my own health, and how I will care for my own health.  My interest is in health care that is affordable, that treats illness and promotes my good health without draining my bank accounts in the process.

I want the President and the Congress to return to Earth and address these real questions about health care.  I want health care reform.  I want a debate on health care reform.  I have yet to see one.