How Joe Wilson, Sarah Palin Killed the Healthcare Debate

In less than 48 hours, Rep. Joe Wilson's two little words have lifted the relatively obscure congressman into what could only be called Sarah Palin Status. It's a dual status. To their party, both are maverick heroes. To their detractors, they represent something between a morbidly fascinating joke and the perfect strawman. In liberal company, after all, "Did you hear what Palin said?" is the political equivalent of "A dyslexic walks into a bra." There is no punchline. The joke has already been told.

And by offering themselves up as jokes, they (and we) do the same to our health care discussion. Just as Sarah Palin's death-panel blathering obscures what should be a substantive debate over how to cut Medicare costs without harming services, Joe Wilson's locker-room shout-out caricatures the real controversy about health care for illegal immigrants.



First, let's take the death panels. The idea that the government wants to force your grandfather to discuss end-of-life solutions with his doctor while a faceless panel gives your grandmother the thumbs down on her 90s is so ridiculous, it would only be interesting to talk about if it came from a Philip K. Dick novel rather than Palin's Facebook page. But like a literal eclipse, this small thing obscures something bigger and more important. To cover the cost of health care reform (now standing at about $900 billion over ten years) the government hopes to find most of its savings in Medicare. Cutting $500 billion from Medicare might be good and necessary -- to eliminate waste, to improve care, and to save money -- but it also might also affect services. How exactly, we cannot know. And since any discussion about service changes in Medicare is drawn, centripetally, into the whirlpool of death-panel nonsense, it becomes dangerous to debate these matters seriously at all.

And what about health care for illegal immigrants? Wilson's unscrupulous yelp didn't put a fine point on the debate as much as it smashed any future discussion beyond recognition. Is Obama's health care bill designed to cover illegal immigrants? Of course not. Might health care reform unwittingly provide health care to some illegal immigrants? Of course it might. Forty percent of all undocumented workers have access to health care right already, according to the Pew Hispanic Center. Does anybody expect that number to go down when the government extends health care benefits? "The health reform plans on the table will create new incentives for illegal immigration," writes James R. Edwards, Jr. of the Center for Immigration Studies. Is he right? He might be. But it's quite hard to say so when the debate is a caricature between "Liars!" and the "Lying liars that yelled 'Liar!'"

And too bad. Fiscal conservatism and a practical approach to immigration should be virtues, especially when both qualities have been so lacking through the last eight years. Instead certain Republicans' gift for shameless quips, and our cult fascination with them, ensure that we will continue in the great American tradition of fighting over cartoons. Joke's on us.