The Health-Care Wars Are Only Beginning

From Fred Barnes at the WSJ:

On Dec. 7, 1941, an announcement was made during the football game between the hometown Washington Redskins and the Philadelphia Eagles. All the generals and admirals at Griffith Stadium were instructed to report to their duty stations. Little did they know their lives would be changed forever and America would be at war, or on war footing, for the next half-century. Pearl Harbor had been attacked.

America will be in a constant health-care war if ObamaCare is enacted. Passage wouldn't end the health-care debate. Rather, it would perpetuate ObamaCare as the dominant issue for decades to come, reshape politics, create an annual funding crisis in Congress, and generate a spate of angry lawsuits. Yet few in Washington seem aware of what lies ahead.

We only have to look at Great Britain to get a glimpse of the future. The National Health Service—socialized medicine—was created in 1946 and touted as the envy of the world. It's been a contentious issue ever since. Its cost and coverage are perennial subjects of debate. The press, especially England's most popular newspaper, The Daily Mail, feasts on reports of long waiting periods, dirty hospitals, botched care and denied access to treatments.

A Conservative member of the European Parliament, Daniel Hannan, last year in an interview on Fox News denounced the NHS as a "60-year mistake," declaring he "wouldn't wish it on anybody." As prime minister, Margaret Thatcher bravely cut NHS spending in the 1980s, but current Tory leaders regard criticism of the NHS as too risky. "The Conservative Party stands four square behind the NHS," its leader, David Cameron, said in response to Mr. Hannan.

.House Speaker Nancy Pelosi believes ObamaCare would have a more congenial fate—that it will become as popular as Social Security and Medicare with voters. She's kidding herself. Social Security and Medicare were popular from the start and passed with bipartisan support. ObamaCare is unpopular and partisan. It's extremely controversial. Its passage is far more likely to spark a political explosion than a wave of acceptance.

Democratic leaders believe the public doesn't focus on the process of how legislation is enacted. But in this case they're wrong. I've been amazed at how many people understand "reconciliation"—a process that allows budget and spending bills to pass in the Senate with only 51 votes, instead of 60. Many voters are also now studying the details of the "Slaughter solution," which would allow the House to "deem" the Senate health-care bill to have passed without actually voting on it and then to vote through changes to the Senate bill. These legislative shortcuts are already infuriating ObamaCare's opponents.

If ObamaCare passes, sooner or later the backlash against it would morph into a movement to repeal it. Republicans would likely make repeal a top issue in congressional elections this November. The GOP is expected to win a substantial number of seats in Congress this fall. If Republicans take control of the House or Senate or both, clashes over health care would be unavoidable.

Assuming it passes, ObamaCare wouldn't go into effect fully until 2013. This fact alone would make the health-care plan a paramount issue in the 2012 presidential race, regardless of whether Mr. Obama is on the ballot. As long as he's president, Mr. Obama would surely veto legislation to repeal or gut ObamaCare. With a Republican in the White House things would be different. Republicans might be successful in dismantling the program.

But Democrats wouldn't give up. Having gone to great lengths to enact ObamaCare, they'd go all out to protect it or revive it. Mrs. Pelosi is already talking about expanding ObamaCare. She favors adding a "public option" to compete with private insurers. "Once we kick through this door [and pass it], there'll be more legislation to follow," she told liberal bloggers on Monday.

So the struggle would go on and on. If you think the fights over funding of Medicare and Medicaid in recent years have been unpleasant, wait until the funding battles over ObamaCare start. It's all but inevitable that they would occur every year given the way Mr. Obama has proposed to finance his health-care program.

ObamaCare low-balls its cost and exaggerates the means for paying for it. "Our proposal is paid for," the president insisted in a speech in Ohio on Monday. It's not. The financing includes billions that are obligated elsewhere. It claims to cut the budget deficit by $118 billion but achieves this by borrowing hundreds of billions more.

At the same time, Mr. Obama's plan offers a cornucopia of new benefits: free preventive care, coverage for those with pre-existing conditions, guaranteed issue, no lifetime or annual benefit caps, and subsidies for insuring 30 million people now uninsured. All of this would increase the use of health-care services. The tendency is to underestimate just how large this increase might be. This was true with Medicare and Medicaid, whose costs have ballooned far beyond initial projections. The annual struggles in Congress over funding for ObamaCare would be intense.

The courts would also get involved. In anticipation of passage of the president's health-care plan, three states—Virginia, Idaho and Utah—have passed laws to nullify ObamaCare's mandate that everyone purchase health insurance. Other states are expected to follow suit. Arizona voters will decide the matter in a referendum in November. Ultimately, federal judges would decide if these state laws are constitutional. Other issues would also end up in court. That includes the constitutionality of the process that Democrats used to pass ObamaCare. We could expect years of litigation.

Enacting ObamaCare would be only the beginning. The controversy surrounding its passage and how it might work would preoccupy the president, Congress and millions of average Americans for the foreseeable future—and then some.

Mr. Barnes is executive editor of the Weekly Standard and a commentator on Fox News Channel.