In my latest Forbes column, I argue that ObamaCare is not the end of our health care battles -- it is the beginning. The bill that's currently in the works will usher even fiercer confrontations--not only on health care but on constitutional matters of governance as well--that will make the current battle look like the political equivalent of a spit-ball fight.
The constitutional battles will arise because netroots activists will try and reinstate the public option or government insurance that is now all but dead.
The biggest impediment to their ambition--as the current health care battle has made clear--isn't going to be evil Republicans or the venal insurance industry, but America's system of checks and balances. In particular, the Senate filibuster ...
But it can't be abolished without a bruising political battle. To the extent that most laws involve an expansion of government power, scrapping it will inevitably empower the government against its citizens. What's more, a president--a minority of one--will be able to override Congress with a stroke of his pen. But even 49 senators won't be able to stop him from ramming his agenda through their chamber.
And the health care battles will arise because what Congress is doing right now amonts to a de facto nationalization of our health care system.
Such systems always and everywhere face a contest between competing interests trying to capture scarce medical dollars. If, say, women with breast cancer shame political authorities into approving expensive cancer-fighting drugs, men launch their own campaign to shift medical dollars to prostate cancer treatment. Patients who lack the political savvy or represent disfavored causes--obesity, smokers, homosexuality--inevitably get relegated to second class medical status. If money poses an unfair obstacle for patients in a market-based system as progressives allege, can they with a straight face claim that the political establishment doesn't pose a far bigger obstacle in a government-run system?
Read the whole thing here.