I have had an unsettling feeling that I have seen this health care reform debate before. These townhalls remind me quite a lot of President Bush's Social Security roadshow in 2005. Not specifically the disruptions -- without the disruptions, they would merely look like dog-and-pony shows that accomplish very little. I want Congressional hearings and white papers, not townhall meetings. We have had precious little of those in preparation for a huge increase the government's role in health care. It is not that there is no academic research to draw on -- it is that the government has not been drawing up the sort of blueprint that used to accompany major legislative initiatives.
More ominous to me is how I think it is all going to end, which is a repeat of Medicare Part D in 2003. In that episode, the President signaled very early that he wanted to sign "a bill." The House passed one bill. The Senate passed another bill. And almost every good idea in either one seemed to disappear in the subsequent conference committee. And it took major arm twisting and giveaways to get the final bill passed. I think President Obama has sent the same signal about health care reform. With the Democratic control of both houses, they will eventually get enough support to pass something in each one. The dirty work will be done in conference committee, and some time after the beginning of the new year, something will be signed. Not necessarily something thoughtful and good, but something that my kids will have to pay for in higher taxes over their whole working lifetimes.