Not surprisingly this midterm season, Democrats are desperate to change the topic of conversation — to anything but Obamacare. Republicans shouldn't let them.
Sylvia Mathews Burwell, President Obama's pick to succeed Kathleen Sebelius as head of the Department of Health and Human Services, is no doubt a smart person. (You sort of have to be to get a Rhodes scholarship.) But she has no background in health care and her only previous experience in the administration was running the Office of Management and Budget. I guess in this administration that qualifies her to run one of Washington's biggest bureaucracies and to address all the problems still plaguing the president's health care law.
The nomination, coupled with all the fanfare that was given to the 7.5 million sign-ups for Obamacare exchanges at the March 31 deadline, is clearly part of a strategy by the president and the Democrats to declare victory, start afresh, and keep voters from asking about all the things that went wrong and still haven't been fixed about this atrocious law. I think the American people understand exactly what's going on and aren't about to be fooled this time. But congressional Republicans also have a golden opportunity to hammer home the message when Ms. Burwell goes before the Senate Finance Committee for her confirmation hearings.
I truly hope those hearings go beyond just the nominee's qualifications and her thoughts on department policies. Senators — especially the Republicans on the panel — should use the hearings to go deeply into the whole question of Obamacare, its constitutionality, its impact on the American health industry, its financial viability. This could be one of the last great chances to really demonstrate to the American people the disaster that is Obamacare and to stop it in its tracks.
One would expect the Democrats to try to protect their president's nominee, but here are a few questions I really think the committee should put to Ms. Burwell:
Is Obamacare constitutional? It would be interesting to hear directly from the nominee where in the U.S. Constitution it says that the federal government has a role and a right to be in the health care business at all. And it didn't start with Obamacare: We have 50 million people in Medicare, 80 million people in Medicaid, more than 10 million enrolled in children's insurance programs, and now 7.5 million signed up in the Obamacare exchanges. That's about 150 million people — just under half of the entire population — on some kind of government health plan without a shred of justification that can be cited in the nation's foundational document.
What has been the impact of Obamacare on the qualify of health care? With all the talk of numbers and polls, quality of care is one issue that nobody seems to be talking about. Waits to see a doctor are getting longer, hospitals and other health-care providers are increasingly stressed, patients and their physicians have to navigate an ever-expanding maze of regulations, mandates and rules. My experience has always been that when the government gets involved, the costs go up and the level of service goes down. Obamacare is proving no exception, and Ms. Burwell should be forced to confront it.
What problems lie ahead? After so much bad press, Democrats may think they finally have a bit of good news on the Obamacare front, but I'm convinced even bigger pitfalls lie ahead. President Obama has put off many expensive mandates from the law — for individuals, for small businesses — until after November's vote. It's the duty of the Senate Republicans at the confirmation hearing to really get into the bills that have been put off but that will inevitably come due for the American people.
Beyond posing the implementation questions, my advice to the senators would be: Go big. Don't get caught up in a debate with the Democrats on the little questions, the problems with this or that part of the program. Focus instead on big issues, such as what that nation's health care system is going to look like in 10 years. What will be the long-term impact on doctors, hospitals, patient care? Is it the president's vision to model U.S. health care ultimately on the model in Europe and Canada, a government-run, single-payer health care system with all the problems and bad incentives that we see in those places? Why are we agreeing, without any real debate, to a vast redistribution of the nation's wealth, with millions of people each year now able to claim subsidies for their health care taken directly out of the pocket of the taxpayer?
We may not get many satisfactory answers out of Ms. Burwell in these hearings, but Republicans can lay down a marker in the bigger debate over the future of Obamacare.
Before the Affordable Care Act and its subsidies become entrenched, now is the time to fight back. With each new entitlement program from Washington, the Democrats put the American people in another box they can't get out of. That's the game plan here, too — shape the political debate so that Obamacare can never be reversed.
Republicans can say clearly they are not going to play that game. Obamacare doesn't need to be replaced. It doesn't need to be repaired. It needs be repealed. Period. And the federal government should get out of the business of health care, where it has no constitutional right to be. It may take years, but there's no better time to start than when Ms. Burwell takes her seat in the committee hearing room.
• Tom DeLay, a former congressman from Texas and House majority leader from 2003 to 2005, writes a weekly column for The Washington Times and www.washingtontimes.com.