Newspaper columns, cable talking-head shows, and blogs are filled with recriminations from the left and a certain amount of gloating from the right: how did Obama manage to lose the health care debate? (That in and of itself isn’t a good thing for Obama while the debate is going on. His effort to achieve a government-run health care plan isn’t dead — not yet.) The arguments fall into two general categories, both of which get it slightly wrong.
From the supporters of ObamaCare, we hear that the cardinal error was getting all concerned about health care costs. John Cohn of the New Republic is typical:
Had he spent more time reminding voters that reform would provide them with the security they now lack — security from financial ruin and medical catastrophe, the type private insurance too rarely provides — he probably would have been better off. …
The trouble for Obama is that, in getting serious about cost, he gave critics lots of fat, juicy targets. Obama proposed to tie payments to quality; Betsy McCaughey said he would be giving doctors money for pulling the plug on grandma. Obama proposed to put a board of experts, using clinical evidence, to set Medicare payment rates; Sarah Palin interpreted that as creating a “death panel” that would declare the sick and disabled unworthy of treatment. The great irony is that by trying earnestly to craft a plan that could control costs, as well as expand coverage, Obama has provoked a political backlash that will make cost control harder in the future. He’s tried to tackle health care like a grown-up and, at the moment, he’s suffering for it politically.
But, as Cohn points out, it’s a little hard to avoid talking about cost when the public sees $9 trillion in debt spanning over the next decade. Perhaps Obama shouldn’t have gone hog wild on the stimulus or should have passed a responsible budget rather than the $3.5 trillion monstrosity, but once he did all that he really didn’t have a choice but to try to address the cost issue.
And there is nothing wrong with talking about cost; it is the type of cost reduction which government-centric health care entails which is the problem. Once Obama decided to go with the standard fare liberal health care model, he was locked into the main cost-saving scheme which just about every other nationalized health care system around the world must employ: rationing. He could have looked to increased private sector competition to lower insurance costs. He could have taken a whack at unnecessary procedures and high medical malpractice costs by working on tort reform. But neither of these holds much interest for Democrats. So he was therefore driven into the sort of cost-saving which has proved to be an anathema to most Americans.