Republicans Surrender on Health Care

by Ramesh Ponnuru

Conservatives shouldn’t be dismayed by the failure of the Republican bill–against which there were excellent arguments. They shouldn’t even be dismayed by the fact that the bill was so flawed. Health care is a huge and complicated issue, different Republicans have different views, congressional Republicans have not had to come up with a governing agenda since the late 1990s, and on and on.

What conservatives should be dismayed by is that Republicans are taking the failure of this bill to be the last word on Republican health policy for, as Speaker Ryan put it, “the foreseeable future.” And it’s not just Ryan and President Trump. Other Republicans seem more eager to blame each other for failure–it’s the Freedom Caucus’s fault! it’s Trump’s! it’s Ryan’s!–than to ask why exactly Republicans are quitting after only a few weeks.

The Democrats spent more than a year passing Obamacare; they spent, arguably, seven decades building support for it. Republicans are making a deliberate choice, right now, to continue being less serious on this issue. It is one within their power to reverse.

The Art of the Fumble

by Kevin D. Williamson

Donald Trump, the great negotiator, failed to talk Republicans into voting for a Republican health-care bill. A few thoughts:

One, Trump’s reputation as a maker of great deals has been oversold. Replacing decades of bad health-care law and bad health-insurance policy with something that is market-oriented — while also addressing the risk aversion of Americans worried by the unpredictable nature of health insurance and health-care costs — is, as it turns out, not very much like negotiating a zoning variance in Atlantic City.

Two, Trump still doesn’t seem to understand this. Reactions to Paul Ryan’s opening gambit on health-care reform were pretty negative. Trump insisted that “we’re going to have tremendous support.” Speaking about congressional Republicans, he said, “I’m already seeing the support not only in this room, I’m seeing it from everybody.” He was wrong about that. Bluster only goes so far when the campaign is over, and Trump doesn’t have what it takes to bully conservative representatives from safe districts in Texas and Oklahoma into voting for legislation that doesn’t meet their standards. He doesn’t seem to have done enough thinking about the basic policy questions to really even understand what those standards are. Congressional Republicans would do well in the future to assume that the president’s only real role in health-care reform is going to be signing the bill in a big, beautiful Rose Garden ceremony.

Three, Republicans — incredibly — haven’t figured out what they want. Sean Hannity, on his radio program this afternoon, faulted Republican health-care reformers from failing to consult “the best and brightest” at the Washington think-tanks and policy shops, i.e. the very “Establishment” that he and Trump and other conservative populists have been raging against for more than a year. The course of action that will provide conservative populists with their cherished moment of closure — “Ding dong, Obamacare is dead!” — is different from the course of action that will create a consumer-oriented and market-driven health-care regime that is popular not only among true believers but also in the rather larger demographic of Americans not working at Cato or AEI. Maybe next time around they should try sorting that out before offering the bill.

Paul Ryan has an impossible job. But it is his job, and it is going to be up to congressional Republicans to provide the real leadership on this issue.

But this is not the first time a bill has failed. And it was not a very good bill. Republicans still have time to do better, if they can figure out what exactly it is they actually want to do.

Feinstein’s Anti-Corporation Rhetoric Doesn’t Square with Her Corporate Campaign Donations

by Austin Yack

During this week’s Supreme Court nomination hearings, Senator Dianne Feinstein, the ranking Democrat on the Judiciary Committee, portrayed Judge Neil Gorsuch as a biased judge who has consistently ruled in favor of corporations. If Gorsuch is not for the “little guy,” Feinstein’s line of questioning went, how could he be an acceptable nominee for the Supreme Court?

Gorsuch vehemently denied having some sort of pro-corporate agenda, explaining that as a judge his “job is to apply and enforce the law,” regardless of who the parties are in a particular case. Solely ruling based on the law and facts in question — and not allowing his personal beliefs to influence his ruling — sometimes results in outcomes that he, too, does not necessarily like. This answer wasn’t sufficient for Feinstein. She continued to question whether he would be a justice for “the big corporations” throughout Gorsuch’s nomination hearing.

Feinstein’s implication was that she, by contrast, is a true champion of the “little guy,” who stands opposed to the interests of large corporations. But a glance at her campaign donations from 2011 to 2016 suggests otherwise, as she has accepted hundreds of thousands of dollars from corporate employees and lobbyists.

Feinstein’s campaign committee has accepted large campaign donations from employees of and lobbyists representing Edison International, PG&E, Wells Fargo, Time Warner, DISH Network, Intel, Sony, Oracle, Comcast, Chevron, and JPMorgan Chase & Co, to name a few.

Edison International employees, for example, donated almost $100,000 to Feinstein’s campaign committee from 2011 to 2016; its lobbyists donated $18,000. Over at General Dynamics, a global defense and aerospace company, its lobbyists donated a total of $33,750, while its company’s employees donated $28,750.

It is perfectly permissible for Feinstein to accept campaign donations from individuals representing big corporations. But her willingness to accept their largesse doesn’t quite square with her political posturing in questioning Gorsuch: Apparently, even if she doesn’t think corporations should get a fair hearing in the court of law, she’s got no problem with taking their money.

The Bill Is Being Pulled

by Rich Lowry

Per CNN. That makes more sense than going through the charade of a doomed vote.

Latest Poll on Planned Parenthood Defunding Is Misleading

by Michael J. New

Yesterday afternoon, Quinnipiac released a new poll on the House GOP’s health-care-reform bill, the American Health Care Act (AHCA). The poll shows that 61 percent of respondents oppose cutting off federal funds to Planned Parenthood. After respondent were told that this funding “was being used only for non-abortion health issues such as breast cancer screening,” opposition to defunding Planned Parenthood increased to 80 percent. The poll has already received coverage from a number of media outlets including Politico, Fortune, Time and

Unfortunately, both this Quinnipiac poll and a Kaiser Family Foundation poll released last week contain many of the same flaws. Neither poll mentions Planned Parenthood’s numerous legal and ethical troubles — specifically the group’s mishandling of Medicaid funds and its willingness to help minors circumvent parental-involvement laws. Neither poll mentions that money is fungible, meaning that the half a billion federal dollars flowing to Planned Parenthood each year still indirectly subsidize abortion. Finally, and most importantly, both polls misstate what the AHCA and other defunding bills would actually do. Proposed legislation would not merely defund Planned Parenthood; it would also reallocate that funding to over 10,000 federally qualified health centers (FQHCs), which offer comprehensive health services to over 24 million people a year, 14 million of whom are women. (This map illustrates how drastically community clinics outnumber Planned Parenthoods, by a ratio of 20 to one.)

Polls can be useful in describing the dimensions of public opinion to policymakers. When dealing with controversial issues, reputable polling firms will often release the results of multiple survey questions to show that responses are sensitive to question wording. However, when it comes to life issues, many polling firms often appear interested only in providing ammunition to abortion-rights groups and their allies in Congress. Gallup frequently asks the “pro-life” vs. “pro-choice” question, because up until recently, Americans were more likely to describe themselves as “pro-choice.” Questions about pro-life policies that enjoy broad support, such as parental-involvement laws, are asked much less often. This latest poll from Quinnipiac provides yet another unfortunate example of a polling firm advancing an ideological agenda instead of usefully contributing to an ongoing policy debate.

What Is Good About the Ryancare Bill

by Quin Hillyer

Of course the Ryancare bill before the House is neither as good as conservatives in our deepest (non-reconciliation-restricted) desires would want, and not even as good as it could be. But it does represent a number of major improvements under current law.

Somehow, I think everybody is missing the significance of the Medicaid changes.

For 20 years (!!!) conservatives have wanted to block-grant Medicaid to the states. It’s good for the federal fisc and great for the states. If it were so easy to do, we would have done it before. This bill moves a good way in that direction. It is a major, major accomplishment.

For the same 20 years, although with less urgency, we have wanted to put work and training requirements on every welfare-like federal program. We succeeded only once, with AFDC/TANF. This bill now does it for Medicaid, thanks to Representatives Gary Palmer and Morgan Griffiths.

For 25 years, we have steadily, steadily, steadily pushed to create and then expand health-savings accounts. This bill does it to an extent so much better than before as to be nearly fantastic.

For seven years we have complained about all the Obamacare taxes. Some of us have particularly fought the medical-device tax as one that is particularly cruel to suffering patients and particularly job-killing. This bill repeals almost every single Obamacare tax, including the medical-device tax.

And that’s not even to get into the insufficient, but still helpful, improvements in patient choice, market principles, and the like that this bill now contains. And it doesn’t include a number of further concessions to conservatives that the House leadership made overnight.

Put it this way: If this bill were labeled the “Improve Federal Health-Care Policy Act” rather than considered as the repeal/replacement for Obamacare, there isn’t a conservative alive who wouldn’t look at it, compare it to current policy, and say anything other than “Wow, what a great series of wins for us! Cool. Let’s do this!”

And then, having done it, go back to work at fully repealing Obamacare in subsequent legislative efforts (plural). This is a Madisonian system. Chip away, chip away, chip away. Achieve conservative improvements, bank them, and come back for more.

One last note: This vote is not for final passage. The bill will be altered by the Senate and, if passed by the Senate, returned to the House. I absolutely guarantee that the Senate will not pass a bad bill back to the House.


Because just three GOP senators can kill a bad bill by refusing to vote for it. And I absolutely do not believe that of the following long list, all but two would vote to send a crummy bill back to the House:

Ted Cruz
Rand Paul
Tom Cotton
Mike Lee
Ben Sasse
Jim Inhofe
James Lankford
Marco Rubio
Tim Scott
Pat Toomey

Whatever all but two of those senators pass will go back to the House — or nothing will move at all. If a bill does get back to the lower chamber, the House Freedom Caucus can judge it then.

Vote is Scheduled for this Afternoon

by Rich Lowry

But there is some doubt whether it will really take place if they are significantly short. It made sense for the White House to insist in a vote yesterday as a way to pressure fence-sitters. It would be pointless to vote anyway now, even if they know they are going to lose.

The Editors: GorSUCH a Busy News Week

by NR Staff

Check out the latest episode of The Editors, in which Rich Lowry, Reihan Salam, Ian Tuttle, and David French discuss the House health care bill, the continuing “wiretapping” saga, and more!

7 Cabins Booked this Week

by Jack Fowler

And we expect more of the same next week. And you can expect to be totally shut out if you don’t act quickly to do what you know you really want to do: Namely, to reserve a sweet cabin on the National Review 2017 Trans-Atlantic Crossing, aboard Cunard’s remastered and gorgeous Queen Mary 2, sailing from Southampton in the U of K August 31st and arriving in Brooklyn in the US of A on September 7th.

You can find complete information about this on-my-bucket-list, once-in-a-lifetime, yes-it’s-really-that-affordable experience at

Here are three things you should know about this tres bon voyage. The first: Prices start at just $2,577 a person (based on double occupancy), and “single” cabins start at $3,916. There’s a comfortable and spacious stateroom for every taste and wallet.

The second: There is a terrific array of conservative speakers, writers, thinkers, doers who will be with us, including Judge Michael Mukasey, former U.S. Senator Tom Coburn, Heritage Foundation founder Ed Feulner, acclaimed novelist Mark Helprin, British author Douglas Murray, NR editor in chief Rich Lowry, media critic Brent Bozell, NRO editor Charles Cooke, ace conservative counsel Cleta Mitchell, domestic policy guru Sally Pipes, defense expert John Hillen, Claremont Review of Books editor Charles Kesler, conservative academic Daniel Mahoney, NRO editors-at-large John O’Sullivan and Kathryn Lopez, NR senior editors Jonah Goldberg, Jay Nordlinger, Ramesh Ponnuru, and David Pryce-Jones, NR essayists David French, Kevin Williamson, Reihan Salam, and Ian Tuttle, NR ace reporter Jim Geraghty, and NR columnists Rob Long and James Lileks.

The third: NR’s spectacular program includes daily seminar sessions in which our all-star speakers will discuss current pressing issues, plus several cocktail receptions, a smoker, and intimate dining on at least two evenings, and likely three, with our conservative celebrities. We’ve joked before about shuffleboarding with Rich and Jonah, but we’re thinking, yeah, let’s have a tournament. Is that’s not a deal-sealer, I don’t know what is.

Anyway, do sign up today – visit for complete details about the National Review 2017 Trans-Atlantic Crossing.

WH: Hold the Vote No Matter What

by Rich Lowry

We’re beginning to get some indication of the White House reaction to Ryan: 

Barbara Comstock a “No”

by Rich Lowry

Comstock is smart, tough member from a difficult district in Northern Virginia. If she’s a “no,” it’s a very strong sign that this thing isn’t getting over the finish line.

Assisted Suicide Loses in Hawaii

by Wesley J. Smith

Mass legalization of assisted suicide is not inevitable.

Now, after losing recently in New Mexico, add Hawaii to the “not inevitable” list. From the story:

A lack of specifics in the current draft of the controversial ‘Death with Dignity’ bill is partially the reason some lawmakers decided to table the issue.

Lawmakers table controversial ‘death with dignity’ bill following intense debate House Health Committee chair Della Au Bellati told a packed hearing the seven-member committee was killing the Medical Aid in Dying bill because it lacked specifics and didn’t do enough to balance the right to choose death with the need to protect vulnerable people.

“We’re concerned about safeguards, the record-keeping, the physician training to be able to do this prescribing for aid in dying,” Bellati said.

Faithful readers might recall I warned here at The Corner that the then draft Hawaii measure would be substantially lacking in safeguards, because, well assisted suicide boosters only promote safeguards to mask their more radical agenda of moving toward a broad assisted suicide/euthanasia license, as seen in Canada and overseas.

But sometimes, as the trite saying goes, in their zeal, they get over their skis. That appears to have been the case in Hawaii.

Repeat after me: “NOT inevitable!” Onward.

Ryan to the White House

by Rich Lowry

Probably not a good sign for the bill, but we’ll know more soon. The push for this bill was a momentum play and it may be that the momentum is running the wrong direction such that a floor vote would not be a narrow loss, but a big one. CNN is reporting that Ryan is trying to put the ball back in Trump’s court, asking him what he wants to do given that the votes don’t seem to be there now. 

Did the House Bill Get Worse?

‘A New World Has Emerged’

by Jay Nordlinger

In recent weeks, I have written about the “Marine Corps,” by which I mean Marine Le Pen and her body of supporters and peers. For instance, GOP congressmen Steve King and Dana Rohrabacher met with her. King tweeted that they had discussed “shared values.”

She has now gone to Moscow, to visit with Vladimir Putin. She has received millions in Russian loans. She must think that an appearance with Putin is good for her politically. (She would know better than most.) Le Pen has an election — a presidential election — on April 23.

Shortly before President Trump’s inauguration, she was in Trump Tower, but by all accounts did not meet with the president-elect.

After her meeting with Putin, she said, “A new world has emerged in these past years. It’s the world of Vladimir Putin, it’s the world of Donald Trump in the United States, it’s the world of Mr. Modi in India.”

Does Modi belong in Le Pen’s pantheon? Anyway, this is an interesting triumvirate.

About the meeting with Putin, an aide to Le Pen said, “We felt they understood each other, they were on the same wavelength.” I believe this is so. The Russian president wished the French leader good luck in the upcoming elections.

(To read a news story, go here.)

In a recent podcast, Daniel Hannan and I discussed Madame Le Pen. She has pledged to pull France out of NATO, of course. She is an unblushing admirer of Putin — a total fangirl. She believes that Western sanctions against his regime are unjust. And, as Hannan said, she is to the left of the French Socialist party on economics.

What’s more, said Hannan, “she mingles this socialism with an element of nationalism, and we’ve seen that before, and it’s a fairly ugly cocktail.”

Putin’s critics and political opponents tend to drop like flies, you may have noticed. In the past couple of weeks, there have been at least three incidents.

Yevgeny Khamaganov, a journalist, 35 years old, died in an emergency room. This death has so far been unexplained. Two years ago, thugs jumped him and broke his neck. Yet, when he recovered, he continued his work. Amazing, that people do this.

In Kiev, Denis Voronenkov has been shot dead in the street. He was once a member of the Russian parliament. He fled to Ukraine and sought asylum there. He was a key witness in the treason case against Viktor Yanukovych, the former Ukrainian president, who is now protected by Putin in Russia. Voronenkov will testify no more.

Nikolai Gorokhov had an important court date. He is the lawyer for the family of Sergei Magnitsky, the lawyer and whistleblower who was tortured to death in 2009. The day before his court appearance, Gorokhov was tossed from the fourth floor of his apartment building. He is still alive. But he ain’t going to court.

“A new world has emerged,” says Marine Le Pen. A good world? There are people, in Russia and elsewhere, who are working for a better world. A much better world.

One of them is Vladimir Kara-Murza, a Russian democracy leader. I first met him at the Oslo Freedom Forum last year. He had been poisoned and almost died. He was walking with a cane. In early February — February 2017 — he was poisoned again. Again, he almost died. He is now in the United States, and I met with him a few days ago. Will have much to say about him in coming weeks.

Madame Le Pen may be right that the tide of history is with her and her ilk. (A favorite Bob Novak word, “ilk.”) But tides can be changed — for good or ill — by determined people.

Why So Many College Graduates Can’t Really Think

by George Leef

Among the standard claims made on behalf of putting kids in college is that they’ll learn “critical thinking.” (As if plain old thinking isn’t critical, but let that go.) But do they? It’s increasingly evident that instead of turning out sharp reasoners, colleges turn out dullards who believe that their emotions are a substitute for logic.

That’s the argument Georgia State English professor Rob Jenkins makes in today’s Martin Center article.

“Clearly” he writes, “colleges and universities across the country aren’t adequately teaching thinking skills, despite loudly insisting, to anyone who will listen, that they are. How do we explain that disconnect?”

His explanation is that more and more of the college curriculum consists of shabby courses where the professor does the very opposite of teaching critical thinking, but rather instills in students ideas that encourage them to rely on feelings as a guide to what’s right and what isn’t. The “deconstruction” fad is a big part of that, as students are taught that texts have no inherent meaning, but only what the reader sees in them. Same for the notion that truth is relative.

Jenkins writes:

That view runs contrary to the purposes of a “liberal arts” education, which undertakes the search for truth as the academy’s highest aim. Indeed, the urge to deconstruct everything is fundamentally illiberal. Heritage Foundation’s Bruce Edwards calls it “liberal education’s suicide note” in that it suggests the only valid response to any idea or situation is the individual’s own — how he or she “feels” about it.

(Strangely, if a student happens to feel that there’s no such thing as social justice or doubts that climate change is a looming disaster calling for vastly increased government powers, a professor is apt to berate him.)

It’s because students are taught to use their emotions rather than logic to guide their actions that we get so much of the silliness and even vicious behavior (as at Middlebury College and Berkeley) we now witness on college campuses. Jenkins drives the point home, writing, “All of this has a profound impact on students and explains a great deal of what is happening on colleges campuses today, from the dis-invitation (and sometimes violent disruption) of certain speakers to the creation of ’safe spaces’ complete with Play-Doh and ‘adult coloring books’ (whatever those are — I shudder to think). Today’s students are increasingly incapable of processing conflicting viewpoints intellectually; they can only respond to them emotionally.”

Wouldn’t it be fascinating to see what would happen if a parent sued a college that had advertised that it teaches students “critical thinking” for false advertising?

Freedom Caucus Can Just Walk Away

by Quin Hillyer

Members of the House Freedom Caucus have shown they want the moon, or nothing, when considering reform of health-care policy. They aren’t going to get the moon, so what they should do is nothing. If they won’t vote “yes,” they also should not vote “no” and not vote “present” either. Just put out a press release making all their usual assertions that everybody else is a weak-kneed coward unwilling to stand on principle, and then, in a great show of moral purity, walk out of the House chamber in protest just as the vote is being called.

That way, they will be able to signal their disgust without actually killing the only extant vehicle to replace Obamacare with something that tremendously improves Medicaid, expands health-savings accounts, re-introduces market forces into the system, repeals numerous taxes, and reduces the federal debt (compared to current law) bytens or even hundreds of billions of dollars over the next decade.

For the bill to pass the House at this stage, it does not need a majority of all elected House members; it needs a majority of those present and voting. So for every two congressmen who walk out in protest, the number of votes needed for passage drops by one.

A walk-out thus would signal that they strongly disapprove of the bill as currently constituted and that they will oppose it when it comes back from the Senate unless it has been substantially improved. But it wouldn’t undermine their leadership and a new administration of their own party, poke a finger in the eye of fellow conservative Republicans trying sincerely to navigate difficult legislative terrain, or relegate 320 million Americans to a continuation of an unimproved Obamacare system that is a job-killing, choice-destroying, premium-hiking nightmare.

What the Freedom Caucus must understand is that this vote today essentially amounts to a procedural ballot. It merely provides a blueprint from which the Senate can work. The Senate will probably take several months, if the bill is sent its way, to re-mold it and fix any flaws while the Freedom Caucus weighs in from across the Capitol, knowing that its block of votes eventually will be crucial. When the Senate has done its work, the bill will go back to the House — and then, not before, will come the vote on final passage at which time the Freedom Caucus can decide once and for all if the new legislation well serves the American public.

Of course most of the Freedom Caucus believes the Senate will make the bill worse rather than better. But what’s the harm in finding out? Whom does it hurt? To repeat: This vote scheduled for today is not a vote to send a bill to the Oval Office for the president’s signature. This is merely a vote to keep the process going. If the Freedom Caucus doesn’t want to signal assent, fine — but there is no reason it should deny the ability of the vast super-majority of their Republican colleagues to try to uphold their own pledges to replace Obamacare with something better.

There are times to stand firm — and other times to cooperate for the good of the order while at least showing respect for the efforts of usually allied colleagues, even if cooperation just means temporarily getting out of the way.

10 Things that Caught My Eye Today (March 24, 2017)

by Kathryn Jean Lopez

1. The great City of God Twitter experiment continues. (Background on Chad Pecknold’s #CivDei challenge to anyone within the reach of social media here.)

2. On The Federalist: “We parents of disabled children know the pain. The fear. And the pull of despair. But we also know the love. True love doesn’t take the ‘out’ provided by a ‘compassionate’ doctor.”

3. Frank Rocca in the Wall Street Journal: Why Abortion Doesn’t Resonate in European Politics:

The election of Donald Trump has boosted the profile and prospects of the U.S. antiabortion movement. A wave of right-wing populism is also hitting Europe, but on the continent, abortion is almost invisible as a political issue. No major party in the coming elections in France and Germany, or in last week’s vote in the Netherlands, has proposed more restrictive abortion laws.

The disparity between the U.S. and Europe reflects sharply different popular attitudes toward abortion. A 2015 BuzzFeed News/Ipsos poll found that two-thirds of French and British respondents thought abortion should be permitted “whenever a woman says she wants one”—compared with only 40% of Americans. A 2013 survey by the Pew Research Center found that only 19% and 14% of German and French respondents, respectively, saw abortion as morally unacceptable—compared with nearly half of Americans.

4. Sohrab Ahmari in America: DeChristianization in the West is a real threat. But Putinism isn’t the answer.

5. Also in America: Confessions of a Porn-Addicted Priest

6. Ryan Anderson & Melody Wood: Gender Identity Policies in Schools: What Congress, the Courts, and the Trump Administration Should Do

Keep reading this post . . .

Why No GOP Health Care Bill Will Ever Be Really Popular

by Jim Geraghty

From the last Morning Jolt of the week:

Why No GOP Health Care Bill Will Ever Be Really Popular

The conventional wisdom this morning is that Republicans are on the verge of suffering a colossal defeat by failing to unify behind the American Health Care Act.  It’s only a colossal defeat if they let it become one. President Trump has offered a bold ultimatum: if the House doesn’t pass the American Health Care Act, he’s abandoning Obamacare. If this isn’t a bluff to win passage and he genuinely means it, it means he’s more reckless, capricious and more unworthy of conservative support than even his skeptics thought. A presidential declaration that repeal and replacement efforts are kaput for the remainder of his presidency would be the anti-Gorsuch, a giant vindication of his critics from the primary. He denounced Obamacare over and over again on the campaign trail. Now, in the face of predictable problems of a Republican Party divided on how best to replace it, he’s willing to abandon the effort?

Different Republicans are going to have different priorities in what replaces Obamacare. The U.S. health care system is big and complicated and has a lot of problems because it’s trying to address a lot of contrary desires. Americans want health care to be excellent, widely-available, and cheap. Experience tells us we can only pick two of those qualities.

A gigantic lingering problem for any reform effort is that many members of the public have wildly unrealistic expectations about what their health care should be and how much they should pay for it, and no politician in either party has much incentive to be honest about hard truths. There’s a strong argument that the entire concept of insurance doesn’t work well for health care, compared to, say, auto insurance. The vast majority of drivers will not get in a major accident in any given year, and plenty of drivers will go years and years without an accident. Consumers are comfortable with a system where most years, they will pay in a considerable sum and get nothing from their auto insurer for that year.

Auto insurance works because a lot of people pay in and get little or nothing in return (other than peace of mind and meeting the legal requirements), but a few people pay in a little and then wreck their car, and the company can afford the costs of repairs or replacing it and make a profit on top, enough to run lots of ads with that little gecko.

Everyone needs health care eventually. And even if you’re healthy and don’t foresee health expenses in the near future, you can get hit by a bus or fall off a ladder or slice your finger with a steak knife at any time. (That’s one reason why “preventative care” rarely saves as much money as the reformers hope.) Obamacare decreed that insurance should cover birth control, which is a monthly expense. Quite a few Americans take prescription drugs regularly to control chronic conditions. Significant health expenses aren’t as rare as car wrecks, meaning the insurers have to pay out more… which means they have to charge more in premiums.

The way to bring down prices is most markets is supply and demand, but that’s difficult to apply to health care costs compared to, say, shopping for a plane ticket on Expedia. If you’re hit by a bus, you need emergency care and it’s difficult to request the ambulance take you to the less-expensive hospital. People get very attached to the doctors they know and they’ve been seeing for years – thus the importance of Obama’s pledge, “if you like your doctor, you can keep your doctor.” Pediatricians watch kids grow up. People don’t like the idea of breaking off an established care relationship and shopping around.

On paper, we can increase supply, and you’ve seen market forces improve health services not covered by insurance; LASIK surgery and plastic surgeries are the most-cited examples. But while you can increase the number of doctors in the country (and nurse practitioners, etc.) it’s difficult to increase the number of the very best doctors. Even if we somehow forced medical schools to admit more students and produce more doctors, U.S. demand for health care is only going to increase as the Baby Boomers age.

The popular argument on the Left is to declare that health care is a right, and thus shouldn’t be subject to the pressures of supply and demand. It’s a lovely thought, until you start thinking through how this would work, because all health care is the result of someone’s labor. Somebody’s got to go through college and medical school and spend all those years studying to become a doctor or nurse or specialist. Somebody’s got to research and develop the prescription medication. Somebody’s got to invent, design, and build the MRI machine, robotic surgery arm, artificial limb, etcetera. And all of those people expect to get paid, and almost everyone would agree that considering their skill, education, talent and hard work, they deserve to be paid well.

When you declare something is a right, it means it cannot be denied, particularly due to an inability to pay. Which means someone else, i.e., the government is in charge of payment.

Put aside the exorbitant cost of having the government pay for everyone’s health care for a moment. You could argue the “government pays” system is close to what we have with Medicaid… except a lot of doctors find Medicaid payments to be way below far market value, “around 50 to 85 cents on the dollar of the actual cost of medical care.” Many doctors say that they’re still willing to take the personal financial loss that comes from treating Medicaid patients, up until the point that they can’t afford it. As of 2015, only 67 percent of doctors take Medicaid, and only 45 percent of doctors take new patients on Medicaid. Even the illustrious Mayo Clinic announced it is going prioritize non-Medicaid and non-Medicare patients.

The Democratic solution? Introduce laws forcing doctors to accept Medicaid payments. Some gratitude for the caring profession, huh? Making health care a “right” means that doctors are forced to work for reimbursement set by the government. It reduces them to tools of the state.

But this hasn’t sunk in with much of the general public. They still believe that there’s some system out there where they can get the very best care, choose any doctor they like, see any specialist they prefer, and pay little or nothing for it. And until that perception is dispelled, any health care reform proposal will be greeted as a disappointment.

Loch Ness and DRock

by Jay Nordlinger

Long before there was the expression “fake news” — or, as the president tweets it, “FAKE NEWS” — there was the National Enquirer. This was pretty much understood to be the definition of fake news. The Lindbergh baby might have been carried off by the Loch Ness monster — that sort of thing.

While the president labels many outlets “fake news,” he speaks with nothing but respect about the National Enquirer. He did so in his recent interview with Time magazine, whose Washington bureau chief brought up the tale of the Cruz family and the JFK assassination.

Believe me, if the Enquirer ever turned on Trump, instead of supporting him, Trump and his spokesmen would jump on that rag as not worth blowing your nose on.

The Enquirer is one of the issues I take up in Impromptus today, along with Iran, the Gorsuch hearings, the Koreas, and much else.

One of my items is about David Rockefeller, who has died at 101. He was a rare thing, in my experience: a scion of wealth — an inheritor of wealth — who both understood and defended capitalism. (The same is true of Pete du Pont and Steve Forbes.) DRock said, “American capitalism has brought more benefits to more people than any other system in any part of the world at any time in history.”

True. And this point, by the way, was stressed by Arthur Brooks, the president of the American Enterprise Institute, in our recent podcast.

Rockefeller studied with Schumpeter and Hayek, among others. Of DRock’s many privileges, that was one of the biggest.