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Not Over Until It’s Over

The heathcare debate chugs on. As Obama flits from Cairo to Europe, as the Supreme Court nominee explains or doesn’t explain why she said such silly things, and as the deficit and unemployment rate soar there is still healthcare. Some conservatives despair — Obama has come out in favor of mandatory coverage (a flip-flop), possibly taxing employer benefits to pay for it (another flip-flop, big time) and for a public “option,” which means the government will squeeze private insurers out of business. Is this a done deal? Michael Gerson sounds an optimistic note:

The administration, it turns out, has no serious plan to control health-care costs. Government health programs of the type Obama seeks to create are not good at cost control (as Medicare has proved) — unless they aggressively ration expensive care to the seriously ill and elderly (as more muscular European models have done). In the choice between competition and rationing, the Republican argument for competition looks less hopeless.

The political fight on health care remains lopsided in Obama’s favor, but the policy argument is growing more balanced. On the Republican side, Americans will see scary changes and more individual costs; on the Democratic side, government control and possible rationing, at a price we can’t afford. As the debate becomes more complex, the outcome becomes less certain.

This presupposes that when the chips are down Congress won’t have found a politically viable way to pay for this and that Democrats will balk at nationalizing 17% of the economy on a straight party line vote. Perhaps. But if opponents of a nationalized scheme are to prevail they had better get cracking and explain just what Obama has proposed and why it is such a horrid idea. (“He changed his mind!” won’t cut it.) And then if they are really smart they will come up with a reasonable and doable back up that helps begin the transition from employer to individual health coverage and increases rather than eradicates competition. Then we’ll see just how good a salesman Obama can be. (Do we think he can be talked into debating Dick Cheney on healthcare?)


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