I suppose there are levels of hypocrisy. I guess you can be more or less hypocritical – or a bigger or smaller hypocrite – than someone else. But the hypocrisy with regard to health care in Washington, D.C., today is so thick you can cut it with a knife. The weird thing about it is, Democrats and Republicans have literally switched sides in the health care debate. Let’s roll back the clock a few years to Medicare Part D, which was casually referred to as the prescription drug benefit. It was part of the Medicare Modernization Act of 2003. That law was passed in 2003 and went into effect Jan. 1, 2006. The hypocrisy lies in the fact that Republicans who praised Medicare Part D now hate the Affordable Care Act. Conversely, Democrats who praise the Affordable Care Act hated Medicare Part D. Frankly, I see little difference between the framework of the two. That someone could be so effusive about one and so vile about the other completely baffles me. I happen to think both – budget-busting, inefficient government entitlements – are bad laws. Medicare Part D told seniors they had to select a private health insurance plan on a confusing, poorly designed exchange to get prescription drug coverage. Of course, drug makers were allowed – if not encouraged – by the law to charge higher prices because the government wasn’t directly negotiating for drugs as under Medicare and other programs. The Department of Veterans Affairs, for example, is allowed to negotiate drug prices and pays between 40 percent and 58 percent less for drugs, on average, than Medicare Part D. In addition, the middlemen, the insurance guys, made money off the deal, too. Costs ballooned. Bad law. Democrats were right to oppose it. Republicans were fools to vote for it. Comes now the strikingly similar, yet even more expansive and expensive, Affordable Care Act. All Americans, not just seniors, are told they have to buy private health insurance plans on barely regulated exchanges using a convoluted, poorly designed website. The architecture of the program allows insurance companies, care providers and big pharma to get away with charging much higher prices than if the government directly provided the insurance under existing programs. The whole system seems designed to be a massive give away to drug makers, providers and insurance companies. Costs, almost certainly, will balloon. Bad law. Republicans were right to oppose it. Democrats were fools to vote for it. And not so coincidentally with regard to government programs, the rollout of both plans were diasters. Republican opposition to the ACA is so well documented and current, I really don’t need to chronicle it. Republicans say it’s the worst thing since slavery. (Seriously, conservative activist Dr. Ben Carson said that.) Republicans have voted some 40 times to repeal it. They sued it. They shut down the government to defund it. They threatened a budget default to stop it. But let’s take a look at what they were saying about Part D, lo, these eight years ago. (Remember, the law was enacted Jan. 1, 2006.) Rep. John Boehner, February 2006: "The good news is that the competition that's being created has lowered premiums significantly below where Congress thought they'd be when we put the bill together, so the competition side is good. I think the implementation side continues to need to be improved." Rep. Tim Murphy, April 2006: “Any time something is new, there is going to be some glitches. All of us, when our children were new, well, we knew as parents we didn’t exactly know everything we were doing and we had a foul-up or two, but we persevered and our children turned out well ... Rep. Phil Gingrey: “I delivered 5,200 babies, but this may be the best delivery that I have ever been a part of, Mr. Speaker, and that is delivering, as I say, on a promise made by former Congresses and other Presidents over the 45-year history of the Medicare program ... Alright, blah, blah, blah. You get the picture. I can quote dozens of Republicans from 2006 making excuses for the rollout and saying how awesome Part D eventually would be. Those guys sound just like today’s Democrats, don’t they? And here’s Demo Nancy Pelosi in 2006: "Now seniors’ interests are being put last. I think it's a complete embarrassment to the Bush Administration to have a piece of legislation out there that is so confusing, they can't even explain it to anyone themselves. ... Democrats want to replace it. They want to give an extension so that they are not penalized for not understanding something that's incomprehensible to even the Bush administration … It's just not right. It must be replaced and Democrats are determined to do that." And Demo Hillary Clinton in 2006: “Because I worried the bill itself was fatally flawed in its design, I voted against it. But as the date approached for the January 1st implementation, I became even more concerned, and yet despite the concerns of many about what was going to happen, we were unsuccessful in either slowing down the process or making it work better. I mean it is, an absolute embarrassment, outrage, deep heartbreaking disappointment. ... I for one believe we should scrap this and start over. ... We have taken taxpayer dollars by the billions and transferred it to the pharmaceutical companies and the insurance companies as a way to entice, even bribe them to provide drug coverage to the poorest of the poor and the sickest of the sick.” Pelosi and Clinton sound just like today’s Republicans, don’t they? How could all these politicians – in good conscience – hold such diametrically opposed points of view on two very similar pieces of legislation? Now, to be fair, Democrats didn’t file lawsuits or shut down the government over Part D like the Republicans have over the ACA. And over time, Democrats acquiesced and didn’t obstruct attempts to fix the law. Which brings me back to the initial premise of this column. Maybe Republicans are a bit more hypocritical with regard to Part D and the ACA. This does not, however, in anyway change the stunningly obvious conclusion that they’re all hypocrites. Given enough time and issues, I am confident Democrats will unseat the Republicans as champions of hypocrisy. But you know what? There is something on which they all agree – something that gets them all on the same page. Lobbying. Why do you suppose we get dopey health care laws like these in the first place? It’s not because Democrats and Republicans are writing bad laws. It’s because lobbyists for drug makers and insurance companies are writing bad laws. Former GOP Rep. Billy Tauzin was the man hated most by Democrats in Washington when he helped write the Part D law. Rightfully so. He helped ensure Part D was a huge sop to the drug industry, against the better judgment of Democrats. But when it was time to write the ACA, guess who showed up at the table, embraced by Democrats? You know. It was former GOP Rep. Tauzin. By 2009 he was head of the Pharmaceutical Research and Manufacturers of America. Tauzin brokered a deal between President Obama and PhRMA in 2009 regarding the ACA. He was able to cap at $80 billion the amount drugmakers would contribute to the overhaul. In return, the President got PhRMA’s support of the law. In addition, PhRMA agreed to spend north of $100 million on advertising in support of the ACA, and President Obama himself. Look, you can nuance things anyway you want. You can try to make one party look better than the other. But the bottom line is, today's lawmakers don't give a hoot what’s best for their constituents. They care about what’s best for their benefactors – the guys with the big checkbooks. And they’re all hypocrites – in varying degrees, of course.