A 25-Point Toss-Up on the Health Care Debate


At the risk of being flame-broiled here in the blogosphere, I'll ask a question that perhaps belies my ignorance on the issue at hand: why are Democrats now protesting the fact that health insurance costs are skyrocketing? Wasn't the big ideological divide between Obama and McCain that Obama was for expanding coverage, and McCain was for controlling costs? Wasn't the campaign narrative that Obama thought expanding coverage would eventually get you to lower costs, while McCain thought that you should directly attack cost control which would then enable more people to afford coverage?***

I'm biased, I admit, but it's hard not to see these protesters set up the Republicans and insurance companies as some straw man opponent that they get to look good protesting against, rather than admitting that if out-of-control costs were what really riled them up, they may have voted for the wrong candidate in 2008. Maybe McCain's then controversial planks of attacking the systemic distortions first, and his related proposal to eliminate the distortions caused by not taxing employer-funded coverage, would have been the right way to go. But why admit that your candidate's opponent's ideas are worth another look when you can look more righteous hollering at greedy insurance companies and obstructionist Republicans?

I haven't followed the debate in Washington as much as I ought, given that the history books may one day tell us this was THE issue of Obama's first term. So I'm speaking from gut reactions and thin-sliced perceptions (and, perhaps a little cynicism). Somebody please school me as to whether I'm reading this right or wrong.

*** At least that's how I understand McCain's approach, as articulated by his #1 econ dude, Douglas Holtz-Eakin. From a recent interview in Newsweek:

You've also said the country would be better off without the Obama-backed health proposals in Congress. Why?

Health-care reform has twin goals. One is to reform the delivery system [hospitals, doctors, clinics] to make the cost of medical care grow more slowly or even fall—without diminishing quality. There's little of that in these bills. The second is to increase insurance coverage; that's what Obama is about. Politically, it would have been better to do it the other way: start with delivery--system reform and, as savings showed up, plow those into coverage expansion.


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