A health care ramrod

Conventional wisdom has held that one of the main motivating factors in politics is self-preservation. If political suicide is part of the bargain, it won't pass.

So much for conventional wisdom.

The raucous town hall meetings and the opinion polls that consistently showed Americans to be opposed to the health care reform bills in the House and Senate did not stop House Democrats from voting for them anyway on Sunday. President Barack Obama must have incredible political skills in order to push such a thing through despite the cost. Many Democrats now have a high hurdle to jump in order to be re-elected this fall.

There is another piece of conventional wisdom applicable here. It is that leadership by committee is not real leadership at all. In order to the pass this health care reform bill, Democratic leaders had to tweak it here and there to gain support from this or that member of Congress. In the end, they even did the one thing many Americans seem to dislike more than anything else about Congress. They tacked on an important but entirely irrelevant piece of legislation to this one. The Senate reconciliation bill will be attached with a bill to overhaul the nation's student loan program, Some will argue that the loan program rightly belongs to the reconciliation process. But health care reform clearly does not. It was a clever way to circumvent the will of the people.

The other thing this health care solution-by-committee does not do is solve the main problem afflicting the nation's health system — runaway costs. While we believe many Americans agree that insurance companies shouldn't refuse to cover someone because of a pre-existing condition, the fact is that forcing them to ignore that factor will raise the cost of premiums in order to cover the added risk. The bill seeks to counter this by requiring all Americans to buy health insurance or face a fine, but the added customers won't make up for the added requirements.

The bill would not have had a chance if not for the administration's deft decision to pull in the drug, hospital and insurance industries and draft legislation around their wishes. That's why the public option disappeared. It's why there are no price controls on Medicare's prescription drug program. This is how Obama succeeded where President Bill Clinton failed.