by Daniel Henninger in the WSJ explaining “Why ObamaCare Isn’t Flying.” Henninger considers the actual health care industry in the United States—the 512,000 physicians and surgeons, the 2.2 million nurses, the hundreds of thousands of private practices and clinics, the “8,616 separate medical-device companies in the U.S., employing 359,065 people”—in all, the famous “sixteen percent of the American economy” that Obama wants to re-order radically and place under the thumb of government. Those people and businesses
to come under the thumb of government, which is a major source of the opposition to Obamacare, and their industry is too complicated, and too alive, to be reduced to a centralized system.
This is the sound of President Obama’s health-care reform bill crashing to earth:
Senate Majority Leader Harry Reid on Tuesday: “We’re not on health care now. We talked a lot about it in the past.”
Democratic Sen. Dianne Feinstein: “It’s a time out.”
The bill’s advocates can’t believe this is happening. They elected a popular and charismatic Democratic president. With him came a filibuster-proof congressional majority. Done deal. Write the bill, vote it into everlasting life, and burn votive candles to Franklin Roosevelt’s unfinished national entitlement legacy.
After seven nonstop months ObamaCare is failing, just as ClintonCare failed after a year’s effort in 1994. It’s clear there is something inherently wrong in what the Democrats have been trying to do here. What is it?
Podcast: Listen to the audio of Daniel Henninger’s column here.
The answer lies in the often-repeated phrase that they are trying to reform “16% of the American economy.” Why would anyone think it possible in 2010—as politics, economics or mere practical feasibility—to reorder 16% of a $14 trillion economy of 300 million people living in 50 separate states whose geography is 16 times larger than France?
The Obama reformers are driven by the idea that their bill would fulfill a dream running back 70 years to 1939, when FDR failed to win passage of a universal health-care bill.
But this isn’t 1939. It’s not even 1994. American health care, whatever its defects, is today unimaginably complex. What the Democrats are trying to do isn’t just difficult. It’s impossible.
According to data compiled by Hoover’s business research from the U.S. Census, the health-care industry consists of 340,650 separate establishments employing 5,508,926 people. I leave it to a mathematician to calculate the number of possible economic relationships this would produce every day, much less annually .
We have 512,000 physicians and surgeons, 2.2 million registered nurses and a galaxy of different jobs orbiting around them. Some 36% of these are in individual physicians’ offices.
One of the jewels of this collection of professionals, which the politicians say is “failing” us, is the U.S. medical-device industry. It has come a long way since the days of “The Clinic of Dr. Gross” in Thomas Eakins’s famous painting.
There are 8,616 separate medical-device companies in the U.S., employing 359,065 people. Within the device industry, its two largest categories are electronic and precision equipment and surgical appliances. These are the wizards of American medicine.
The president says the special interests oppose his bill. But to pay for the bill, Congress would levy a $2 billion annual tax on the medical-device industry, which ardently opposes the legislation.
Let’s pick a state. How about suddenly famous Massachusetts. The Massachusetts Medical Device Industry Council lists more than 220 companies as primary members. They have weird names like Aeris, ExtruMed, Bioxcell and WunderThink. Yet the Democrats are agog that Massachusetts voted Scott Brown into the Senate.
Harvard Medical School Dean Jeffrey Flier said of the health-care bill in these pages recently that “our capacity to innovate and develop new therapies would suffer most of all.” And that’s the high-minded criticism of the bill. Down at the level of simple retail politics what you see are tens of thousands of separate health and medical interests that understandably are in motion because of this bill’s determination to change everything in American health care.
The president and his health-care advisers are giving philosopher kings a bad name. Only people who have reduced American health care to rows and columns of data in academic studies would think it possible to remake this incredibly sophisticated organism as easily as rebooting a spreadsheet.
You can’t do it.
Meanwhile, press reports this week also noted that Mr. Obama’s “comprehensive climate bill” is being down-sized to something that can pass Congress. Same problem.
Barack Obama is 48 years old, a “young” president. But in a sense, he is an old 48-year-old. The House leadership, the committee chairmen leading his agenda, are old guys from the 1960s and ’70s. The so-called progressive Democrats who make up his core base are essentially a labor movement stuck in a one-size-fits everything industrial model from the 1930s.
It is a revealing irony that the other big story this week is the phenomenal steady success of Apple’s iPhone, the result of a basic platform opening itself to a zillion application companies. Probably 90% of those tiny app firms voted for Barack Obama, whose idea of how the world actually works could not be less like their own.
Senate Minority Leader Mitch McConnell’s suggestion that Mr. Obama start over is better advice than he knows. Refashioning America’s terrific health-care industry from basic platforms might even be exciting. That won’t happen. The Democrats will ride their, and Mr. Obama’s, 70-year-old national-entitlement dream straight to November, and over the cliff.
Write to henninger@wsj.com