The House Health Care Debate–The Right Thing to Do

The House begins debating a bill to repeal last year’s health care bill. Although the chances of actually repealing the health care law are vanishingly remote, this is the right thing to do.

First, chances of repeal are vanishingly remote for fairly obvious reasons. Although the Republicans have a majority in the House, and can probably pass it there (since the majority dominates in the House–one book on Congress explains their process not as actual legislative deliberation, but as domination by party cartels), they are still a minority in the Senate. And even though the Democrats’ majority is small and their unity fragile, meaning some Dems would conceivably vote for repeal, the majority controls what gets put on the agenda. And even if the repeal did miraculously get through the Senate, due to a wholesale collapse and retreat by the Democrats, the President would veto it, and neither chamber could muster anything remotely like a veto-proof majority.

So why waste time on something that has no chance of passing? It’s pure political posturing, right? Well, not really. First, “position-taking” is an important task in politics, because it sends important messages to one’s constituency. Even dictators engage in position-taking to appeal to their public and keep enough support–or enough lack of serious opposition–to deter threats to their regime (c.f., Kim Jong Il). It’s particularly important in democratic polities where the citizens get a regular chance to vote against you.

Of course politicians send lots of signals that are pure political posturing. The legislator who sends his constituents a mailing announcing all the bills he’s submitted is engaging in signaling, even though he may have submitted bills that he knows don’t have any chance of ever being addressed in committees, and even though he may not actually care about them and may put exactly zero effort into following some of them up. That type of signaling falls on the “pure symbolism” end of the symbolism-policy continuum (much like President Bush’s “Mission Accomplished” moment).

Most often the constituents won’t know, and won’t bother to find out, if their representative is actually putting in real effort on their issues, but occasionally they get suspicious. When a politicians repeatedly makes promises that he makes no real effort to follow through on (such as President Reagan’s vows to eliminate the Department of Education and to repeal Roe v. Wade, they can develop a problem of “credible commitment.” In fact since no one seems to really trust politicians, credible commitment is perpetually problematic for them.

But by taking time to formally debate and vote on repeal, House Republicans are demonstrating credible commitment. Sure, a cynic can argue that it’s not really credible because they know their efforts ultimately have no chance of becoming law, but cynics aren’t the target of this signal, the House Republicans’ constituents are, and they’ll mostly take the signal seriously. And they should, because cynicism aside, many of these House Republicans really do believe in repeal, and they want people to know they really do believe it, and aren’t just paying lip service to that goal.

We want politicians to take their promises seriously, so we can’t legitimately fuss when they do.

Second, this is good democratic politics, precisely because the Republicans are responding to their constituency. It’s easy to make excuses for not putting in any effort, but that makes for lousy democratic responsiveness. Whatever these House Republicans may truly believe, many of their constituents do hate the health care law, so it’s appropriate and proper that they debate and vote on it.

Third, there are a lot of people who are either convinced the health care bill is a bad bill, or who simply don’t understand it at all, who aren’t necessarily opposed to the overall concept of public provision of health care. The public as a whole is far from won over on the current law. Further debate can potentially either provide people with further information so they can make up their minds or highlight the bad elements sufficiently to ultimately force changes in the law (I’m not speaking here of repeal, but of amending). The cynic might doubt that the debate will actually shed any light, and I share that doubt. But what is sure is that there is a greater chance of light being shed with debate than without debate. Any important issue that has such tenuous public support is worthy of continued debate and argument.

About J@m3z Aitch

J@m3z Aitch is a two-bit college professor who'd rather be canoeing.
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17 Responses to The House Health Care Debate–The Right Thing to Do

  1. D. C. Sessions says:

    You missed another element: it’s an opportunity to create facts and shape public opinion. For instance, the current position paper on repeal from the House leadership contains a number of factoids that are on their way to becoming “everybody knows” truths.

    Examples include the “doc fix” being attached to the ACA [1], the “jobs killing” interpretation [2] of the CBO analysis, etc.

    [1] The “doc fix” is an annual ritual that’s been going on since 1998, and has bupkis to do with the ACA. However, it’s a big budget number.
    [2] Estimates are that thanks to not needing to stay in their jobs to get insurance, about 0.5% of the workforce will leave it. Which means that unemployment will go down, not up — but that’s not the way it’s being told to the public.

  2. Pinky says:

    I have a suggestion for every person who reads the post and the replies to it.

    Get a copy of the January-February 2011 issue of Harvard Business Review and study it.

    “Old Capitalism” is on its death bed. It will not recover.
    Face it.

    A “New Capitalism” is on the way.
    And, all this hullabaloo about the new Health Care Bill signed into law by President Obama points to it.

  3. Pinky says:

    Only to subscribe

  4. James Hanley says:

    D.C.–I was only focusing on what are positives from the democratic perspective. I think they outweigh the inevitable negatives such as the ones you point out.

    Pinky–It depends on the definition of “new” and “old” capitalism. Perhaps the author(s) define those in ways that would make their argument persuasive. A book I read recently, The Company: A Short History of a Revolutionary Idea, would provide a framework for definitions that would probably persuade me. But I’ve seen so many claims of a “new economy” etc., etc., that didn’t ever pan out that I am a priori skeptical of their claims. But my college library gets the HBR, so I’ll go check out the article.

    Keep in mind, though, that I’m not interested in capitalism per se, but markets. If markets drive changes in capitalism, I’m not going to mourn for the old ways. If anti-market government policies drive changes in capitalism, then I’ll put on my black dress and veil.

  5. D. C. Sessions says:

    D.C.–I was only focusing on what are positives from the democratic perspective.

    I may have gotten somewhat crossed up by the lower-case d adjective.

    Personally, I’m not seeing a whole lot of “debate” being in the cards; this is going to be a set piece and it looks to me as though the House leadership is going to rule pretty much anything but “Motherhood and Apple Pie vs. the Man-Eating Shark” statements to be out of order. One clue is the total lack of committee hearings on the subject (contrary to even the new Rules); the factual basis for any discussion has already been set by the Leadership.

    That’s bad for Democrats, but IMHO it’s much worse for democracy.

  6. I’m inclined to agree with Mr. Hanley’s analysis, even though as a supporter of the law, I’d prefer the Republicans not do this.

    I do think that Republicans are taking a risk by taking a position. It is at least plausible that in 2012, Democrats will try to bait, and might even be successful, their Republican congressional opponents by saying the latter “voted to allow insurance companies to discriminate on preexisting conditions, etc.”

    One question for Mr. Hanley: I haven’t read The Company:…. Do you recommend it?

  7. James Hanley says:

    D.C.–But Republicans can’t totally control the debate. Democrats and the media can participate as well.

    Pierre–I highly recommend it. I wish there were more books like it, a short quick read but providing a lot of new information in an interesting way. A key is that they’re relying on Ronald Coase’s theory of the firm, which essentially says that firms develop when the cost of administration becomes less than the cost of contracting, and they show how that led to the development of firms, and how it is now leading to much less hierarchically organized companies. For example, near the end they mention a computer company that is actually nothing more than an office suite of programmers. When you order one of “their” computers, the order goes directly to UPS (I think, maybe Fed Ex), and never through the company itself. UPS transmits the order to the contractor that assembles the computer, picks up the assembled product and delivers it, and iirc the payment actually transmits through the shipper to the company’s bank.

    In part what’s brilliant about the book is that it cuts through a lot of the babble about “new economies” and shows how a lot of the change is explained by a simple idea first expounded half a century ago, before anyone could have foreseen the change.

  8. D. C. Sessions says:

    As long as we’re forking off in the direction of Coase’s work, have y’all seen Benkler’s Coase’s Penguin?

  9. James Hanley says:

    Sigh, more to read. Don’t you guys realize I don’t have time for reading when I have three courses to teach and a book to write?

  10. D. C. Sessions says:

    So don’t. You wouldn’t like it anyway.

  11. D. C. Sessions says:

    Well, the “debate” is over. As predicted, it consisted of short talking-point speeches by the majority, after which the minority spoke to a mostly empty chamber.

    After a few hours (yup, deep thinking) the predictable party-line vote and the bill goes to its death in the Senate.

  12. James K says:

    James, The Company sounds like an interesting read, and it runs parallel to some of my thoughts since I read Coase’s theories back at uni. In many ways the 20th Century was the Century of Big: big governments, big companies, big wars. The defining technologies: mass production, television were high economies of scale businesses that demanded large firms.

    But the 21st Century augurs the possibility of a return to small. That may make the world less historically grand, but hopefully a better place to live.

  13. James Hanley says:


    So why wouldn’t I like it?* And why Penguins?

    *I suspect I wouldn’t like it just because it looks like an article about economics published in a law journal. The track record on those, imo, isn’t so great. Too many law profs seemed to get their only economics education in law school itself.

  14. D. C. Sessions says:

    Yanking your chain. As for Benkler:

    CV above.

  15. ppnl says:

    I don’t think Republicans want to repeal health care. If they do it goes away as a powerful tool to motivate the base and they will then have to deal with the negatives. Worse someone may ask them to come up with a different plan. That would be bad. Real bad.

    (Unless they can get democrats to pass the republican plan over the objection of republicans. Then it’s communism and they can get elected by promising to repeal it.)

  16. Pinky says:

    The powers behind the Republican Party are getting what they want: lowered costs for labor and products; so, their money will do more for them.

    But, it is being done on the backs of all the lower classes. They will keep it up as long as they can get away with it.

    It’s a dangerous game.

  17. Michael Heath says:


    I finished my analysis of Gov. Snyder’s State of the State but don’t have an email to send it you. You can email me at and I’ll reply.

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