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A strange health care debate

Tom Jackson • Oct 4, 2012 at 5:35 PM

In general, the Wednesday night debate seemed more interesting and more substantial than presidential debates I've sat through in the past. But the portion of the debate that discussed health care neglected an important topic.


President Obama spent much of the debate attacking the Republican proposal to convert Medicare into a voucher system. He argued that government health care is more cost-effective than private health care.


But if he believes that, why is ObamaCare built around making everyone buy for-profit health insurance? Why did he take extending Medicare off the table early in the discussions?


Obama's health care reform program essentially is a Republican program. Back in 1993, when President Bill Clinton was pushing his health reform plan, and Republicans believed for political reasons that they had to offer a plan of their own, they suggested a plan drafted by the conservative Heritage Foundation. It included an individual mandate for everyone to buy health insurance and subsidies to help people who couldn't afford to buy insurance.


After Clinton's health reform package failed, and Republicans no longer felt the need to feign interest in health care, the GOP plan was shelved. You'll notice that Republicans did nothing to extend health care coverage when they controlled the White House, the Congress and the Supreme Court. But when Mitt Romney helped install a health reform package as governor of Massachusetts, Romneycare essentially followed the outlines of the old Heritage Foundation plan. And Obamacare closely resembles RomneyCare.


Speaking of Romney, he did little last night to answer the question that has dogged him all through the campaign. If Romneycare worked in Massachusetts, what's wrong with extending it to the other 49 states?


About that individual mandate: During the 2008 campaign, Obama's main Democratic primary opponent, Hillary Clinton, leveled with voters and told them that any serious reform plan would have to include a mandate requiring everyone to buy health insurance. Obama opposed a mandate during the primary and said it would not be necessary. Of course, he changed his position after he won the election. Clinton was the candidate who was being honest with the voters, but the news media, then as now firm Obama supporters, tactfully declined to make an issue of the matter.


Even after Obama's "reform," the U.S. does not make sure that everyone has health insurance coverage. And even after reform, our system is a hopelessly confusing patchwork of various government and private programs. We can't be bothered to simply make sure everyone is covered, but we have special programs to cover veterans, the elderly, American Indians, poor people who happen to live in an urban area with a federal-sponsored clinic, and on and on and on, with each program featuring a different set of rules and regulations.


Every other advanced country has a health care system that controls costs and covers everyone. Perhaps after the election is over, we can have a discussion about why everybody else's health care system is better than ours.

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