Health care: Who’s got the best reform plan?

Think there are no significant policy differences between Hillary Clinton and Barack Obama? said Paul Krugman in The New York Times. I have two words for you: health care. Both Democratic hopefuls have plans that would require private insurers to offer policies to everyone, regardless of medical history, while also giving people the option of buying government-offered insurance. But there’s a “big difference”: Clinton would mandate that everyone have insurance, while Obama would not. Many commentators have called Obama’s plan more moderate and therefore more likely to survive what promises to be a bruising political fight. But if the goal is “universal health coverage,” Obama falls woefully short, since his plan would still leave millions uninsured. And because Obama has “demonized” Clinton’s mandated approach as onerous, should he become president, “the enemies of reform would use his own words against him.”

Yet their differences pale compared to what they have in common, said James Capretta in National Review Online. Both “would lead to a government takeover” of health care, which many Americans rightfully find appalling. By creating a massive government insurance program, the Democratic plans could “so destabilize existing private insurance arrangements” that soon enough, the government system would entirely consume the private one. Then we’d likely see price controls, loss of choice, and other hallmarks of nationalized medicine. Republicans have a better idea, said Grace-Marie Turner in The Wall Street Journal. They would provide tax breaks to people who purchase insurance on their own—thus “bringing millions of new buyers into the health-care marketplace.” The new competition would force insurers and providers to offer more affordable options—which is what Americans really want.

What Americans want, said family physician Steve Huff in the Roanoke, Va., Times, is a system that works. As it now stands, 40 million Americans lack health insurance, while even those who have insurance are straining to afford their medical care. Meanwhile, a new study by the nonpartisan Commonwealth Fund rated the U.S. “dead last” among industrialized countries for quality of health care. As a doctor, I am naturally put off by anything that smacks of “socialized medicine.” But a system in which the government provides insurance—not health care itself—works well in France and could work here, too. “I am bone tired of telling patients they need a test or treatment or referral that they cannot afford,” and I am fed up with “the hegemony of Big Medicine over lawmakers, clinicians, and patients.” Merely tweaking that system won’t suffice. “Pitting profit against health is killing us.’’

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