Robert Zelnick writes: “Everything about the House-passed bill smacks of political excess rooted in ideological purity.” He then tries to puzzle out who the bill is supposed to help. What about the poor and uninsured? “Well, most of the truly needy are already protected by Medicaid. Most of the rest: employed married folks who have chosen the risky but comprehensible path of self-insurance?” So there isn’t a big net plus — or a group of grateful voters whose votes are sufficient to balance all the angry conservatives and independents. What about cost containment? As Zelnick says, “the bill does nothing.” But there are many who are getting socked:

The bill slaps s series of tax boosts on the earnings of those in the quarter million per year bracket and above together with taxes on investment, corporate earnings, other “unearned” (i.e., job-creating investment income) and estates, again nothing remotely linked to the subject of the legislation.

And there are the seniors who will find their Medicare curtailed. Again, more pain for a group of regular voters.

It’s therefore quite possible that the public (at least those who vote consistently) won’t — even after a sales job — come to appreciate the wonders of the bill. There just aren’t that many wonders. It is, as Zelnick points out, quite different in this regard from popular entitlement programs (“social security was carefully tailored to satisfy a pressing need for security among the elderly while Medicare and Medicaid also responded to well defined public need”). Here there is a lot of pain with uncertain gains. And that’s before we consider the aggregate impact on the nation’s fiscal health.

Perceptions change over time, but it’s hard to see how this becomes the sort of beloved entitlement plan that Democrats hope will earn the voters’ gratitude.

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