At the risk of sounding too pessimistic, here are a few predictions of what will happen now that the House has passed HR 3590 by a vote of 219-212, and once President Obama signs the bill into law:
• Several states and thousands of individuals will sue to enjoin the federal government from enforcing the law. Most of those cases will fail. The Supreme Court will wound, but not kill, the law. The 10th Amendment will be effectively read out of the Bill of Rights. And even if the individual mandate is voided, it won't much matter when the vast majority of private insurers are regulated out of business.
• The Republicans will take back Congress in November, but the margins will be insufficient to mount a successful repeal effort. This will be a great disappointment to many voters, who will stay home in 2012. Unfortunately, those disappointed voters would have voted for Obama's opponent.
• The regulations will be worse than anyone can imagine. The result will be to force out of business all but two or three of the largest health insurance companies in the United States. Those companies will eventually be protected by future legislation aimed at "fixing" the flaws of HR 3590. But in practice, the companies will be government proxies.
• American quality of life and lifespan will fall slightly over the next 30 years. The reason lifespan won't decline significantly is that federal regulators will successfully tax or ban substances or foods it deems harmful to Americans' health -- which, we will soon learn, is an expensive commodity indeed.
• The United States will never have a single-payer system quite like that of Canada or the United Kingdom. Rather, it will be a two-tiered system that still gives the very wealthy and well-connected access to care and treatment that the vast majority of Americans simply cannot receive.
• The new system will not reduce the deficit. It will not cut waste, fraud or abuse. Congress will need to pass new laws against new crimes that innovative con men and swindlers will invent to exploit or circumvent this law.
• There will be other unintended consequences nobody today can imagine. How do I know? Because it was ever thus.
• Most Americans will shrug and try to go along to get along. We'll be a poorer people, if not in wealth, then in spirit. I likely won't live to see the worst of it -- ironically, I'll have the feds to thank for it, I'm sure -- but my kids will.
Some glib fool on Twitter wrote after the vote: "It sounds so calm outside! And America is still here!" Of course it is, you preposterous ass. Freedom ends not with a bang, but a whimper.
Update: David Frum offers a few bullet points of his own in a post titled, perhaps appropriately, "Waterloo." The gist:
It’s hard to exaggerate the magnitude of the disaster. Conservatives may cheer themselves that they’ll compensate for today’s expected vote with a big win in the November 2010 elections. But:
(1) It’s a good bet that conservatives are over-optimistic about November – by then the economy will have improved and the immediate goodies in the healthcare bill will be reaching key voting blocs.
(2) So what? Legislative majorities come and go. This healthcare bill is forever. A win in November is very poor compensation for this debacle now.
So far, I think a lot of conservatives will agree with me. Now comes the hard lesson:
A huge part of the blame for today’s disaster attaches to conservatives and Republicans ourselves.
At the beginning of this process we made a strategic decision: unlike, say, Democrats in 2001 when President Bush proposed his first tax cut, we would make no deal with the administration. No negotiations, no compromise, nothing. We were going for all the marbles. This would be Obama’s Waterloo – just as healthcare was Clinton’s in 1994.
Only, the hardliners overlooked a few key facts: Obama was elected with 53% of the vote, not Clinton’s 42%. The liberal block within the Democratic congressional caucus is bigger and stronger than it was in 1993-94. And of course the Democrats also remember their history, and also remember the consequences of their 1994 failure.
This time, when we went for all the marbles, we ended with none.
Frum wonders if compromise was possible. Compromise may have been possible, but hardly desirable. The result would have arrogated to the benefit of the state. "So today’s defeat for free-market economics and Republican values is a huge win for the conservative entertainment industry," Frum writes. "For the cause they purport to represent, it’s Waterloo all right: ours." Frum should perhaps have a drink and find some nerve. What happens going forward, even if defeat is inevitable, requires men of character and possessing strong stomachs. I strongly doubt that David Frum is such a man.