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Paul Hayden

Health Care – The Rough Road Ahead

November 23, 2009

President Obama's plans to dramatically reform health care in America passed the House of Representatives in an extremely close vote, despite the fact that it is increasingly unpopular with the American people. Now it is the Senate's turn. The going should be much tougher in this body, for several reasons.

The procedural rules of the House and of the Senate are dramatically different. The Speaker of the House is, perhaps, the second most powerful position under our constitutional system. The procedural control which that officer has, in conjunction with the power that any majority party has in the House of Representatives, makes it hard for the opposition political party to slow down the majority party.

The rules of the Senate are much different. For most of our nation's history, debate in the Senate was virtually unlimited. One single senator, provided that he held the floor, could continue debate on any measure before the Senate virtually indefinitely. If several senators operated in collaboration, legislation could virtually be stopped forever. Later the Senate adopted rules of cloture, requiring initially three-quarters of the Senate to invoke cloture, a supermajority that has been reduced over time to the current three-fifths majority.

The purpose of this is to give individual senators an extraordinary amount of power, and this tends to transcend partisan differences more than in the House of Representatives. As a consequence, Senator Reid may not be able to find the sixty votes he needs to bring any measure related to health care to a vote on the floor of the Senate. Beyond that, it means that individual senators who support health care may be reluctant to surrender the power of filibustering by allowing Reid to use some artifice, like Budget Reconciliation, to end run cloture. If the current Majority Leader of the Senate was able to ram through legislation with a simple majority in the Senate, then a future Majority Leader of the Senate would be able to do so as well – including a repeal of health care proposals passed by Reid.

Aside from a possible filibuster, the Senate gives disproportionate strength to smaller states. President Obama won a fairly easy electoral victory over Senator McCain in 2008, but in spite of his popular vote and electoral vote majority, Obama only carried twenty-seven of the fifty states (which translates, in terms of senators, to fifty-four senators.) Among those states Obama carried were Virginia (which strongly rejected President Obama in the elections last week), North Carolina (whose constituency is similar to neighboring Virginia), Indiana (which Obama carried by a very narrow margin), New Mexico (a state in which Democrats recently lost the mayoral race in Albuquerque in a stunning upset), and other states which historically have resisted big government, socialist legislation.

In several of these states, Democrat senators face re-election in 2010. Senator Lincoln in Arkansas may face an unhappy electorate if she supports Obama's plans for health care reform. Senator Dorgan in North Dakota faces a potential threat from the most popular governor in the nation, Republican John Hoeven, and Dorgan's vote on health care could help Hoeven decide whether to challenge him or not. In an election year which seems likely to favor Republicans, the loss of just a few Democrats in states that have historically been Republican in presidential politics could doom the Democrats' healthcare plans.

This is especially true because the issues at stake are correctly perceived to be monumental. Senators can sometimes rationalize a disagreeable vote to constituents back home by dismissing the importance of the vote or alleging that the issues are too complex for voters to understand or that the vote cast was really a compromise vote. Each senator's vote on health care, however, is perhaps the most important – and the most indicative – vote that the senator will likely cast in his Senate career. The electorate is highly polarized and profoundly engaged. A vote by Senator Lincoln for an Obama endorsed health care scheme will be the defining issue in her reelection campaign.

If a bill makes it out of the Senate, the conference committee will have issues to reconcile which may be irreconcilable. Hostility to the pro-life movement has been at the heart of the Democrat Party since Governor Casey was denied the opportunity to address the Democrat Convention in 1992. About forty House Democrats are committed to oppose any bill which allows for the funding of abortion in the proposed health care reform. Senior citizens, who vote in large numbers, particularly in mid-term elections where the vote is usually small, by the time of the conference committee report, will have time to absorb the actual impact of government allocation of finite health care resources.

Passing a huge health care bill through the House of Representatives was the easier step in President Obama's plans to make health care a government program. Getting a bill out of the Senate and then back to both houses in a conference committee bill appears a much tougher proposition.

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Copyright ©2009 Bruce Walker

Bruce Walker is a long-time conservative writer whose work is published regularly at popular conservative sites such as American Thinker.