GOP Health Care Train Wreck

Ezra Klein details the cynicism and dishonesty revealed by the Republican health care debate on vox.com.

The health care debate has revealed a political system unmoored and in crisis.

Part of it is the recklessness of the legislation under consideration. Putting all policy arguments aside, no one — including congressional Republicans — believes these bills to be carefully drafted. House Republicans passed the American Health Care Act before seeing a final Congressional Budget Office score — they didn’t want to know what it did, and they didn’t want anyone else to know either. Senate Republicans moved to debate their bill on the floor before they knew what their bill was.

Republicans are making life-or-death policy for millions of Americans with less care, consideration, and planning than most households put into purchasing a dishwasher.

But the deeper problem — the one that will continue to corrode the system long after this debate resolves — is the role that deception has played throughout the process.

This has been a policymaking process built, from the beginning, atop lies. Lies about what the bills do and don’t do. Lies about what is wrong with Obamacare and lies about what the GOP’s legislation would do to fix it. Lies about what Republicans are trying to achieve and lies about which problems they seek to solve.

This isn’t just a moral offense, though it is that. It is a profound challenge to the policymaking process.

For the most part, the political system — from voting to journalism to policymaking to congressional debate to interest group organizing — is built around the idea that the signals sent by the central players are meaningful, even if the rhetoric is often slippery. That’s how policymakers coordinate with each other. That’s why journalists report what politicians say in speeches. That is why activists organize based on what policymakers propose. That’s why voters tune in to presidential debates and party conventions.

This is not to be naive. Politicians fib, prevaricate, misdirect. They exaggerate and make untenable promises, like Mitt Romney’s mathematically impossible vow to make deep, deep cuts to tax rates without losing a dollar in revenue or raising the burden on the middle class, or Barack Obama’s insistence that the Affordable Care Act would not cancel a single American’s health insurance plan.

Still, the lying tends to be marginal, not central. If you listened to Romney, you would conclude that he wanted to cut taxes; if you listened to Obama, you would conclude that he wanted a new program to expand health insurance coverage. Politicians can typically be counted on to try to fulfill their campaign promises. They tend to try to do what they said they would do, if only to signal to their allies how to fall in line, and to ensure their voters know which side they’re on.

From day one, the argument all Republicans could agree on was that their replacement bill was needed because Obamacare’s individual markets were collapsing — too few young and healthy people were buying insurance, and a fix was needed. This was false as a broad claim but true in some markets.

But now Senate Republicans look to be ending their process with a bill that mainly repeals the individual mandate, and thus sends far more markets into collapse. And so the one vaguely real problem they identified and repeatedly promised to solve they are now making much, much, much worse.

This is not normal. It is crazy-making. It’s a debate where words have no meaning, promises have no value, noise carries no signal. A functional policymaking process cannot survive in this environment for long.

For years, the senators I interview on both sides of the aisle have privately expressed their despair, their disappointment, their humiliation. Few legislators today take pride in their work or believe the era in which they serve will be remembered with admiration and honor. In these discussions, I always ask the same questions. Why not buck leadership? Why not act in the way you think is honorable, if you think the institution is rotting around you? Why not band together with your similarly angry colleagues and refuse to let anything pass unless changes are made?

I have never gotten a good answer.

Skepticism is healthy in politics. But this era requires more than skepticism. This is a total collapse of the credibility of all the key policymakers in the American government. Our political system is built on the assumption that words have some meaning, that the statements policymakers make have some rough correlation to the actions they will take. But here, in the era of bullshit politics, they don’t. If this becomes the new normal in policymaking, it will be disastrous.