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President Obama and Vice President Biden exhibit starkly different debating styles. However, last night’s debate showcased in important similarity-one that speaks volumes about why four more years for this duo would be bad for the country in general and our health care system in particular. It’s their undisguised arrogance and contempt for those who may disagree with them.
While Al Gore’s sighs and groans in the 2000 presidential debate rank a close second, nothing in the 50 year history of these election-year debates rivals the openly contemptuous attitude of Vice President Biden on display in his unrelenting eye-rolling, smirking, cynical laughter, and 82 interruptions of his more sober, serious (and frankly, polite) rival across the table. This “I can’t believe what this clown is saying” attitude had been communicated with equal force by President Obama last week through his dismissive, disengaged performance and body language that signaled to the world that debating with the likes of Governor Romney was far beneath him and that he had better things to do with his time.
This administration’s arrogant attitude is nothing new to anyone who has been paying attention. During the 2008 campaign, then-candidate Obama boasted:
I think that I’m a better speechwriter than my speechwriters. I know more about policies on any particular issue than my policy directors. And I’ll tell you right now that I’m gonna think I’m a better political director than my political director.
Similar arrogance was on display just three days after his inauguration when he announced “I won” to explain why he didn’t need to accept Republican ideas for how to structure the stimulus bill.
But what does this have to do with health care? This know-it-all attitude neatly sums up both how we got the “Affordable” Care Act and its deeply flawed design.
During the campaign, one of candidate Obama’s greatest appeals to Independents was his promise to fix Washington and end partisan division. In late 2007, he assured the Concord Monitor: “we’re not going to pass universal health care with a 50-plus-one strategy,” alluding to the “working majority” he planned to assemble to get this monumental task done. Yet once in office when push came to shove, he did not hesitate to ram through the most sweeping reform of health care since Medicare on a pure party-line vote-a maneuver completely without precedent in American history.
Unprecedented as well was the president’s decision to arrogantly and flagrantly ignore the public’s wishes. Since the summer of 2009, public opinion had consistently shown sharp opposition to the president’s health plan, with opponents consistently outnumbering those who favored the plan by 8 to 10 percentage points in poll after poll.
In late January 2010 in what NPR characterized as a “staggering blow” to the president, Republican Scott Brown-running on a very explicit platform of being the 41st Republican vote against “Obamacare”-achieved a stunning come-from-behind victory to fill the Massachusetts Senate seat previously held by Senator Ted Kennedy. By February 2010, the RealClearPolitics.com average of public opinion polls showed opponents of the bill (54.4 percent) outnumbering those who favored it (37.4 percent) by a full 17 percentage points. In light of the prospects that the health reform effort would go down in flames just as President Clinton’s plan had 18 years earlier, the president’s chief of staff, Rahm Emanuel pleaded for some common sense by scaling back his health reform aspirations through a bipartisan deal.
However, the president and Nancy Pelosi-convinced they were on the “right side of history“-decided in that moment to plunge ahead with a strategy to enact the law on a pure party-line vote. And in explaining to his party members why they should risk their seats in 2010 by casting such a risky vote in light of how badly Democrats had fared in 1994 in the aftermath of the Clinton health reform debacle, the president immodestly explained ‘Well, the big difference here and in ’94 was you’ve got me.’
Recall that it was Congressman Paul Ryan who weeks before enactment eloquently pleaded with the president not to go forward with his plan, succinctly explaining how the plan about to be enacted would violate all of the president’s firm and oft-repeated promises: a) that his plan would not add one dime to the deficit; b) that it would not increase taxes at all for the middle class; c) that it would bend the cost curve; and d) that people could get to keep their current coverage if they liked it. Although revisionists are fond of twisting the truth to claim that the president’s strategy was forced by recalcitrant Republicans unwilling to enter into a bipartisan deal, Avik Roy deftly exploded that myth months ago.
The president and former House Speaker Pelosi both mistakenly (some might say arrogantly) believed that once people understood the plan, they would come to support it. It turned out the American public was not nearly as stupid as ACA’s advocates apparently believed. They were furious that their wishes had been ignored. From the get-go, polling around repeal of the bill mirrored the attitudes towards the plan before it was enacted. In repeated polls across a variety of sources, a majority of the public favored repeal of Obamacare by a margin that typically exceeded 10 percentage points over those opposed to repeal. You might think that the thumping his party took in the 2010 elections (at least one solid empirical analysis has shown that “health care reform may have cost Democrats their House majority)” might have humbled the president and made him more amenable to a bipartisan fix to his deeply flaw health plan. But he has repeatedly made it clear that he believes the debate is over and need not be “relitigated.”
Obamacare itself reflects this same contempt for public opinion and persistently favors trumping individual choice with government edicts. The plan’s designers do not care if you have a religious objection to paying for contraceptive coverage for your employers. The First Amendment notwithstanding, Obamacare tramples religious liberty in favor of a ‘government knows best’ approach. Likewise, the tsunami of new rules ensure that tens of millions of Americans-including millions in Medicare Advantage plans-will lose their current coverage even though they were perfectly happy with it and even though their president assured them this would never happen.
I personally don’t want know-it-all government experts deciding for me what kinds of health benefits I’m “allowed” in my health plan, or an unelected 15-member panel making decisions that will fundamentally affect my parents’ access to Medicare. Are we a nation of children who cannot be trusted to make good decisions for ourselves and need the paternalistic hand of government to guide us every step of the way? Or are we a nation of adults who can take responsibility for our own decisions about preventive services or contraception and pay for what we decide we need without government interference. The attitude conveyed by President Obama and Vice President Biden appears to be “we know best.” In the face of those on the other side of the aisle who politely disagree, their attitude appears to be that compromise is beneath them, especially when they are the right side of history.
Pride goeth before fall: from where I sit, this duo deserves to be toppled. Only then can we get the kind of health reform that Americans deserve.
 Avik Roy already has done a masterful job of unpacking the vice president’s truth-twisting as it relates to health policy, so I will not waste time trying to duplicate his efforts.
 Seasoned political commentators from the left and right generally took a dim view of these not-very-presidential antics.
 In the end, the bloated stimulus bill was enacted without a single Republican vote in the House and only 3 votes in the Senate.
 For example, a majority of Republicans in the House voted in favor of Medicare and Senate Republicans were nearly evenly divided when that law passed in 1965. Likewise, House Republicans voted more than 5 to 1 in favor of Social Security and Senate Republicans voted more than 3 to 1 in favor. This puts a lie to revisionist claims that these programs have been steadfastly opposed by Republicans from the get-go. Note that in both cases, the Democrats held far more commanding majorities in both chambers of Congress than in 2010. Thus, in principle, Presidents Roosevelt and Johnson might well have elected to drive through a version of their plans more to their liking on a purely partisan vote, but recognized the foolishness of such a divisive strategy.
 Even progressives such as Rep. Barney Frank retrospectively conceded that President Obama made a mistake in not backing down on health reform after the Scott Brown victory in January 2010.
 The president, for example, said 6 months after the bill’s passage: “I think that health care, over time, is going to become more popular.” More pointedly, Nancy Pelosi in the aftermath of last June’s Supreme Court decision asserted that she was proud of the health care law and that “politics be damned” predicting that the legislation will become more popular with the American people over time.
 Of more than 135 polls tracked by RealClearPolitics.com since March 2010, only a lone CBS poll conducted in January 2011shows opponents of repeal outnumbering those who favor repeal. Once again, such sustained public opposition to a signature piece of domestic legislation is completely without historical precedent, a measure of just how far out of touch this administration is from the average voter.
President Obama and Vice President Biden exhibit starkly different debating styles.
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