When Congress passed and the President signed the Health Care and Education Reconciliation Act of 2010, virtually no single person knew or understood what was in it or what would result from its passage.  Nancy Pelosi famously said, “But we have to pass the bill so that you can find out what is in it, away from the fog of the controversy.”  I’m not sure it was so much the ‘fog of controversy’ as it was the fog induced by trying to understand thousands of pages of legalese and references to other legislation.  To be fair to Ms. Pelosi, she was probably right to say that nobody would know what was in the law until it was enacted and operating.

An article today in the Wall Street Journal points out that a single issue, Medical Loss Ratios, could have a monstrous affect on the direction of health care in the U.S. and yet how it affects us is entirely up to new bureaucrats in new agencies created by the new law and which don’t yet exist.  It appears that government bureaucrats will decide which providers are allowed to provide which services at what prices.  That is to say, ‘we have to pass the bill so that you can find out what is in it.”

This brings me to my questions.

1.  Why would anyone want to turn over to bureaucrats the control of such a basic individual responsibility as caring for one’s own health? Should I also turn over to my government the control of my basic responsibility to find food and shelter for my family?

2. Do I really want disinterested bureaucrats to decide how I should spend my health care dollars? If I have the money to get plastic surgery to change the shape of my nose should I have to ask Big Brother for permission?  Conversely, if I don’t have the money for the plastic surgery, but can convince a bureaucrat that I need the surgery to boost my self esteem and help me find a job, should tax money pay for my new nose?

3.  Can the Government actually run health care more effectively than free markets? Since State and Federal governments have been toying with the health care market for years, have we actually seen what markets will do to correct themselves?

4.  Is the action of our Congress to take control of health care seen as a good solution or is it seen as a move towards a true Nanny State where our government knows best and must protect us from ourselves?

5.  Is this just a case of Congress doing the right thing and not explaining it well to the people, or has Congress underestimated the people? Will there be a huge backlash at the polls this November?

I think the vote in Missouri on Tuesday goes a long way to answering these questions.  It appears that, at least in Missouri, the people think that the Congress has overstepped its bounds.  Will we see more of this in the November election?  I think we will.  Any time you can get over 70% of the people to agree on a ballot measure, the politicians are going to have to study both the measure and the vote.  I think many will conclude that this was not a vote against government health care, just against a mandatory coverage provision.  I think they will be wrong.  I still think that Congress in general underestimates the general public rejection of a government health care scheme.  This will be one of the most interesting discussions leading up to the November Election.